The Signalling Programme GSM-R Handheld
Appendix 3, Attachment 1 Change Order
GSM-R Handheld Tender Document Appendix 3, Att 1 Change Order Template SP-16-067557
Page 2 of 10 Banedanmark
Signalling Programme Amerika Plads 15 DK-2100 Copenhagen Ø Denmark
Author: The Signalling Programme GSM-R Handheld Mail:
Phone: +45 8234 0000 Phone direct:
Appendix 3, Attachment 1 Change
Order Template
Table of Contents
Page
GSM-R Handheld Tender Document Appendix 3, Att 1 Change Order Template SP-16-067557
Page 4 of 10
1
Change Log
Version Date Status
GSM-R Handheld Tender Document Appendix 3, Att 1 Change Order Template
CHANGE ORDER SUMMARY
Summary of the Change Request
Summary of the Proposal for a Solution
Change Status
Approved X if approved Rejected X if rejected
Customer Supplier
Date: dd.mm.yyyy Date: dd.mm.yyyy
Name: Name of the person approving / rejecting the change
Name: Name of the person approving / rejecting the change
Position :
Position of the person
approving / rejecting the change
Position :
Position of the person approving / rejecting the change
Signatu re:
To be signed when the change is approved/rejected
... ...
Signatu re:
To be signed when the change is approved/rejected
... ...
Name: Name of the person approving / rejecting the change
Name of the person approving / rejecting the change
Position :
Position of the person
approving / rejecting the change
Position of the person approving / rejecting the change
Signatu re:
To be signed when the change is approved/rejected
To be signed when the change is approved/rejected
Requested by Customer /Supplier Project
Customer Contract No: Customer’s contract ID Supplier Contract No: Supplier’s contract ID
Payment None / Instalment / Separately
Price model None / Fixed / Time & Material
Price level Year and index (e.g. 2011 Q3)
Signalling Programme Change Order Related Programme Change Order ID (if relevant)
GSM-R Handheld Tender Document Appendix 3, Att 1 Change Order Template SP-16-067557
Page 6 of 10 Request date dd.mm.yyyy
Name Person responsible for the
request
Position Position of the person responsible for the request
DETAILED REQUEST (To be filled in by Change Initiator)
Change Description
Detailed description of the requested change.
The description shall as a minimum have a level of detail that allows the Supplier to prepare a cost estimate for the preparation of the Proposal for a Solution.
The description shall preferably have a level of detail that allows the Supplier to prepare the Solution Proposal based upon the description once the Customer has accepted the cost estimate for the preparation of the Proposal for a Solution.
GSM-R Handheld Tender Document Appendix 3, Att 1 Change Order Template
SOLUTION COST ESTIMATE (to be filled in by supplier for customer instigated
changes only)
Cost estimate for preparation of the Proposal for a Solution
DKK Enter the cost estimate in DKK
Breakdown of Cost estimate for preparation of the Proposal for a Solution
The Supplier shall detail the Cost estimate for preparation of the Solution Proposal.
The Supplier shall provide full visibility of all costs connected with the preparation of the Proposal for a Solution.
Explanation of Cost estimate for preparation of the Proposal for a Solution
The Supplier shall state the activities involved in the preparation of the Proposal for a Solution to a level of detail necessary to explain the cost estimate.
Submission date
(estimate) dd.mm.yyyy Cost estimate
validity dd.mm.yyyy
Name Person responsible for submitting the cost estimate Position Position of the person responsible for submitting the
GSM-R Handheld Tender Document Appendix 3, Att 1 Change Order Template SP-16-067557
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Proposal for a Solution
Detailed description of the proposed solution.
The description shall have a level of detail that allows the Customer to assess whether the solution fulfils its purpose.
Reference can be made to documents that further describe the solution.
Detailed descriptions of the consequences and the necessary changes to the contract and its
appendices as well as other affected documents shall be provided (see below and at the next page).
The Supplier shall provide full visibility of all costs connected with the change – if any.
The Supplier shall provide an update of the risks (changed and new risks) which can be entered directly into the risk register – if relevant.
The Supplier shall provide exact descriptions of the necessary changes to the contract and its appendices as well as other affected documents. The descriptions shall if possible contain the actual wording of the necessary changes.
Submission date
(estimate) dd.mm.yyyy Cost estimate
validity dd.mm.yyyy
Name Person responsible for submitting the cost estimate Position Position of the person responsible for submitting the
GSM-R Handheld Tender Document Appendix 3, Att 1 Change Order Template
Consequence Table
:
- mandatory sectionsSubmission date
(estimate) dd.mm.yyyy Cost estimate
validity dd.mm.yyyy
Name Person responsible for
submitting the cost estimate
Position Position of the person responsible for submitting the cost estimate
Framework Agreement Schedule 1 List of Customers
Schedule 2 Requirements Specification in the Tender Schedule 3 Template Call-off Notice
Schedule 4 Template Delivery Agreement Appendix 1 Delivery Description
Appendix 2 Prices and Payment Appendix 3 Change Management Appendix 4 Call-off Notice Appendix 5 NDA
The Supplier confirms to have considered specifically if any of the documents/criteria marked with red above are affected by the change
Date: dd.mm.yyyy Signature:
The Customer’s Project Manager confirms that there are no unacceptable safety implications connected with the change
Date: dd.mm.yyyy Signature:
GSM-R Handheld Tender Document Appendix 3, Att 1 Change Order Template SP-16-067557
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CONSEQUENCE TABLES:
Insert as many “Proposal for a Solution, Consequence” tables as necessary
Proposal for a Solution, Consequence: Enter the consequence type (e.g. Scope, App
3)
Describe the consequence in detail
The precise wording in the affected document(s) shall be stated (e.g. Req. no. xxx “…” to be replaced by “…”)
Reference can be made to documents that further describe the consequences. Submission date
(estimate) dd.mm.yyyy Cost estimate
validity dd.mm.yyyy
Name Person responsible for submitting the cost estimate Position Position of the person responsible for submitting the
