Exhibit III_Change Order_WSB Ver II.pdf

PDF 171 KB Posted

Attached to
Master Agreement AZ|CTR053007
Contract number
CTR053007
Issued by
Arizona

About this file

This document is a Task Order Scope of Work Change Request form (Exhibit III) from WSB, which appears to be a department or agency with the ability to modify existing task orders. The form is designed to document and authorize revisions to an existing contract when unforeseen circumstances arise, providing a standardized mechanism for updating task order details.

The form allows for modifications to original task orders by requiring written documentation that details additional tasks, schedules, and specific reasons for revisions. It includes a section for firm fixed all-inclusive pricing to perform additional services, enabling both the WSB manager and the contractor to mutually agree on and authorize changes. The document emphasizes a formal process where both parties must sign the change request, which will be processed as a direct release purchase or change order. While specific contract details are not completed on this template, the form provides a structured approach for contract amendments under unforeseen circumstances.

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Text version

Exhibit III

Task Order Number Contractor Name

Requested By Reviewed By

Change Request Date Contract Number

Additional tasks, schedules, and basis for the revisions per 11.1

Firm fixed all-inclusive pricing to perform additional services

TERMS FOR UNFORESEEN CIRCUMSTANCES

11.1. WSB may allow for task order revisions the event of unforeseen circumstances. Should WSB determine that revisions to original task order offers are necessary, written documentation detailing the additional tasks, schedules and basis (specific reasons) for the revisions along with additional firm fixed all-inclusive pricing to perform the additional services specified shall be executed (signed by both parties) for processing as a direct release purchase/ change order.

DPS/WSB Manager or Authorization Designee Contractor Job Authorization Designee

Authorized Signature Authorized Signature

Printed Name and Badge No. Printed Name and Title

File details come from the government source that posted it. Updated .