Amendment Request Form

Amendment Request Form

Department/Trac Name*

Select

Division*

Select or enter value

Requester*

District Staff Member Email*

Amendment Type*

District Amendment - Definition: Amendments that are developed by San Joaquin Delta College. The District has an amendment template avail for use located at https://deltacollege.edu/campus-offices/administrative-services/purchasing/contracts-documents. Confirm with your Department/TrAC manager if the available template meets your needs.

Non-District Amendment - Definition: Agreements that are developed by the Service Provider. Administration mandates legal review on all Non-District Agreements. It is the responsibility of the Departments/TrAC offices to ensure the changes to the agreement are clearly identified. Check the boxes below to confirm the following has been identified in the amendment. Leave unchecked if not applicable.

District Amendment

Non-District Amendment

What changes are being requested? Check all sections that apply:

Change in scope

Change in price

Change in term

Supplier Point of Contract Name*

Supplier Point of Contact Email Address*

Supplier Point of Contact Phone Number*

Supplier Business Name*

Supplier Authorized Signer Name*

Supplier Authorized Signer Email*

Authorized Signer Phone Number*

Update only if change is being requested:

Amount of Agreement

Update only if change is being requested:

Term of Agreement Start

Term of Agreement End

Location*

Select

Update only if change is being requested:

Scope

Manager Name*

Manager Email:*

Manager Title*

VP Name*

VP Email*

Requester Notes

File Upload*

Upload original agreement and Amendment form:

Amendment Form

Drag and drop files here or

Send me a copy of my responses

Privacy Notice|Report Abuse