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 .