The Signalling Programme GSM-R Handheld Appendix 3, Attachment 1 Change Order Template

The Signalling Programme GSM-R Handheld Appendix 3, Attachment 1 Change Order Template

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: www.banedanmark.dk Page 2 of 10

Appendix 3, Attachment 1 Change Order Template Table of Contents Page 1 Change Log 4 Page 3 of 10

1 Change Log Version Date Status 1.0. Issue for Tenderers Page 4 of 10

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) Incentive/Penalty Yes / No 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: Date: Name: Name of the person approving / rejecting the change Position Position 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 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 Position Position of the person : approving / rejecting the change Name 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 Page 5 of 10

Request date Name Position Person responsible for the request 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. Reference can be made to documents that further describe the change. Page 6 of 10

Submission date (estimate) Cost estimate validity Name Position Person responsible for submitting the cost estimate Position of the person responsible for submitting the cost estimate 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. Page 7 of 10

Submission date (estimate) Cost estimate validity Name Position Person responsible for submitting the cost estimate Position of the person responsible for submitting the cost estimate 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. Page 8 of 10

Submission date (estimate) Cost estimate validity Name Position Person responsible for submitting the cost estimate Position of the person responsible for submitting the cost estimate Consequence Table: - mandatory sections Schedule 1 Schedule 2 Schedule 3 Schedule 4 Appendix 1 Appendix 2 Appendix 3 Appendix 4 Appendix 5 Framework Agreement List of Customers Requirements Specification in the Tender Template Call-off Notice Template Delivery Agreement Delivery Description Prices and Payment Change Management Call-off Notice NDA The Supplier confirms to have considered specifically if any of the documents/criteria marked with red above are affected by the change Date: Signature: The Customer s Project Manager confirms that there are no unacceptable safety implications connected with the change Date: Signature: It is noted that the signature can be replaced by a link to an e-mail from the Project Manager Page 9 of 10

Submission date (estimate) Cost estimate validity Name Position Person responsible for submitting the cost estimate Position of the person responsible for submitting the cost estimate 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. Page 10 of 10