Consultant Work Order

(Local Projects)

Project No.:	Control No.:
Consultant: (Name and Representative)	Agreement No.:	Work Order No.:
LPA: (Name and Representative)	Constr. Change Order No.: (If applicable)
All parties agree the following described work needs to be performed by the consultant as part of the referenced project. All parties concur and hereby give notice to proceed based on the following: justification to modify contract, scope of services, deliverables, schedule, and estimated total fee. All other terms of existing agreements between the parties are still in effect. It is understood by all parties that the work described herein will become part of a future supplement to the agreement indicated above.
Justification to modify agreement: (Include scope of services, deliverables, and schedule)
Work Title	Summary of Fee
A. Total Direct Labor Cost =
B. Overhead (Factor * x A) =
C. A + B =
D. Profit/Fee (Factor ** x C) =
*Overhead Factor:	%	E. FCCM (Factor*** x A) =
**Profit/Fee Factor:	%	F. Direct Non-Labor Cost =
***Facility Capital Cost of Money (FCCM):	%	G. Subconsultant Services =
Total Fee Notes:	TOTAL FEE: C + D + E + F + G =
ESTIMATED TOTAL FEE:
FINAL TOTAL FEE:

Work Order Authorization – May be granted by email and attached to this document.

Consultant:	Notice to Proceed will be granted by email by: LPS PC for Preliminary Engineering & CD PC for Construction Engineering.
Name	Signature	Date
LPA:
Name	Signature	Date
LPS PC (for Preliminary Engineering) and State Rep. (for Construction Engineering):
Name	Signature	Date
LPS Unit Head Review (for PE Phase):
Name	Signature	Date	FMIS Approval Date:
LPS Manager or Construction Engineer (Construction Phase):
Name	Signature	Date
FHWA: (FHWA Approval on Full Oversight Projects Only):	Notice to Proceed Date:
Name	Signature	Date

Distribution: Consultant, LPA – RC, State Rep., FHWA, LPS PC, NDOT Agreements Engineer, Highway Funds Manager, CD PC

NDOT Form 250, November 18