Exhibit D - Work Order Change Form.pdf
PDF 999 KB Posted
- Solicitation number
- 1016A-2025
- Issued by
- Colorado
About this file
This document is a General Services On-Call Contract Work Order Change Form administered by the Department of General Services Contracts Office located in Denver, Colorado. The form is a standard template designed to modify an existing work order, allowing for adjustments to the original contract terms without fundamentally changing the underlying agreement. The document provides a structured mechanism for making changes to a work order, including potential modifications to the total contract amount, work scope, and completion date.
The form includes sections for capturing key contract modification details such as the original work order amount, duration, and completion date, as well as the proposed changes. It requires signatures and approvals from the contractor, using agency, requestor, and division director to validate the modifications. The document specifies that no work can commence until the Work Order Change has received all necessary signatures and a Notice to Proceed has been distributed. The form is intended to be distributed to multiple parties including the Auditor, Contract Administration, General Services Contract Compliance Technician, DSBO, and the Contractor.
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Text version
Administered by:
Department of General Services Contracts Office 201 W. Colfax Ave., Dept. 1110 Denver, CO 80202 GScontracts@denvergov.org
Work Order Title:
Contractor Name: On-Call Contract No.:
Supplier ID No.: Workday PO No.:
Agency: Agency Requestor:
Fund/Cost Center/Spend Category:
It is hereby mutually agreed that when this WORK ORDER CHANGE has been signed by the contracting parties, the following described changes shall be executed by the CONTRACTOR without changing the terms of the Contract.
Modifications to the Work Order described in the attached narrative and summarized in the attached scope of work dated and attached as Exhibit A.
THE CONTRACTOR AGREES to furnish all services, material, labor and perform all work/tasks required to complete the scope of work described and any changes in accordance with requirements for similar work covered by the Work Order Change, except as otherwise stipulated herein, for the following considerations:
($XX.XX) Add/subtract from the Work Order the sum of:
Work Order Revised Completion Date:
Accepted for Contractor By:
Title: Date:
WORKDAY PO NO.: CHANGE REQUEST SUMMARY
Original Work Order Amount: $ Original Work Order Duration:
Original Work Order Completion Date:
This Work Order Change (+/-):
New Work Order Total:
Adjust the Work Order Completion Date by: calendar days New Work Order Completion Date:
USING AGENCY
I hereby certify that funds are available that will be reserved to pay the Contractor in full for the work to be performed under this WORK ORDER CHANGE.
By Using Agency – Administrative or Budget Office Date
APPROVALS
Approved by Requestor, Date
Approved by Division Director Date
NOTE: No persons shall authorize or perform any of the above until the Work Order Change has all signatures and has been distributed alongside a Notice to Proceed
DISTRIBUTION: Auditor, Contract Administration, General Services Contract Compliance Technician, DSBO, and Contractor.
Contractor Signature:
GENERAL SERVICES ON-CALL CONTRACT WORK ORDER CHANGE FORM
EXHIBIT E
mailto:GScontracts@denvergov.org
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