Exhibit III_Change Order_WSB Ver II.pdf
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- Attached to
- Master Agreement AZ|CTR052901
- Contract number
- CTR052901
- Issued by
- Arizona
About this file
This document is a Task Order Scope of Work Change Request form (Exhibit III) used by WSB (presumably a state or local agency) to modify existing task orders when unforeseen circumstances arise. The form provides a template for documenting and authorizing changes to an existing contract, with designated areas for task order number, contractor name, request details, and signatures from both the agency's manager and the contractor's representative.
The form outlines a process for revising task orders, specifically allowing for additional tasks, schedules, and pricing when unexpected situations occur. Section 11.1 details that WSB may permit task order revisions through written documentation that specifies the additional tasks, schedules, and reasons for changes. The form requires firm fixed all-inclusive pricing for any additional services and mandates that the changes be executed (signed) by both the DPS/WSB Manager and the Contractor Job Authorization Designee to process the modification as a direct release purchase or change order.
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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 .