Office Of Space And Building Management (Osbm) Work Request (Page 4 of 4) in pdf

Office Of Space And Building Management (Osbm) Work Request Page 4

INSTRUCTIONS FOR COMPLETING THE CD-410

CHANGE FORM

GENERAL:

Complete SECTION 1, ensuring the Ordering Agency POC has logged the request and filled in

the Ordering Agency Control Number (if applicable) and then forward to the Office of Space and Building Management

provide a cost estimate for the change of work requested via SECTION II. The CD-410 will be

returned to the originating office for review of the cost change and to make adjustments as

necessary. Once the cost estimate for the change of work is agreed, concurrence and approval

to obligate the funds and proceed with the work is completed via SECTION III. A change of

work scope or services will not be provided until SECTION III is signed and returned to OSBM.

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All fields should be typed or printed.

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Separate CD-410 Change Forms should be submitted for each group of changes.

SECTION I: REQUEST FOR SERVICES

Enter the CD-410 Control Number of the project.

Enter a full but concise statement describing the work change requested. Attach additional

information as necessary.

Signature and details of Office/Agency/Bureau’s official authorizing the work change request.

SECTION II: COST ESTIMATE

Enter in all the original project items and original estimated costs for each group of items

(including labor and materials), as well as the original total project cost for the services

requested. Enter in all the new estimated costs for each group of items affected by the change.

Enter in the new total project cost for the services requested. An itemized breakdown of all

costs should be provided via separate attachment if required.

Signature and details of OSBM Project coordinator who prepared the revised estimate.

SECTION III: WORK PERFORMANCE AUTHORIZATION/FUNDS AVAILABLE

Signature and details of Office/Agency/Bureau official authorized to obligate funds and

authorize performance of work or service changes.

Office Of Space And Building Management (Osbm) Work Request Page 4