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 .