Exhibit D - Work Order Change Form.pdf

PDF 999 KB Posted

Attached to
Citywide Emergency On-Call HVAC Repair Services, Excluding DIA (No DSBO Program)
Solicitation number
1019A-2025 (Second Solicitation)
Issued by
Denver County, Denver City, Colorado

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This document is a General Services On-Call Contract Work Order Change Form administered by the Department of General Services Contracts Office in Denver, Colorado, located at 201 W. Colfax Ave. The form is designed to document and authorize modifications to an existing work order without altering the fundamental terms of the original contract. It provides a standardized mechanism for making adjustments to the scope of work, contract amount, and completion date, requiring signatures and approvals from various stakeholders including the contractor, using agency, requestor, and division director.

The form includes sections for recording the original work order details such as the total amount, duration, and completion date, as well as the proposed changes. It requires specification of any additions or subtractions to the work order amount and potential adjustments to the project timeline. The document mandates that no work can commence until the Work Order Change has received all necessary signatures and been distributed with a Notice to Proceed. The form will be distributed to multiple parties including the Auditor, Contract Administration, General Services Contract Compliance Technician, DSBO, and the Contractor, ensuring comprehensive documentation and tracking of the contract modifications.

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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

mailto:GScontracts@denvergov.org

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