Exhibit III_Change Order_WSB Ver II.pdf
PDF 171 KB Posted
- Attached to
- Master Agreement AZ|CTR052953
- Contract number
- CTR052953
- Issued by
- Arizona
About this file
This document is a Task Order Scope of Work Change Request form (Exhibit III) from WSB (likely a government agency or department) for modifying an existing task order. The form provides a standardized template for documenting and authorizing changes to an existing contract or task order, with designated spaces for task order number, contractor name, change request date, and contract number.
The document outlines a process for handling unforeseen circumstances that may require revisions to an original task order. Section 11.1 specifically details that WSB may allow task order revisions when unexpected situations arise, requiring written documentation that includes additional tasks, schedules, and specific reasons for the changes. The revision must include firm fixed all-inclusive pricing for the additional services, and must be executed (signed) by both the DPS/WSB Manager and the Contractor Job Authorization Designee to be processed 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 .