Exhibit III_Change Order_WSB Ver II.pdf

PDF 171 KB Posted

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 .