Change Request Form Project Management

PROJECT CHANGE REQUEST (PCR) FORM

I. DOCUMENT CONTROL

II. LEGAL NOTICE & COMPLIANCE DISCLAIMER

LEGAL NOTICE: This document constitutes a formal amendment to the existing Statement of Work (SOW) or Master Services Agreement (MSA) governing the Project. By signing this document, the parties acknowledge that the modifications described herein may impact project timelines, resource allocation, and fee structures. This document shall be integrated into the governing contract and is subject to the same confidentiality and dispute resolution provisions contained therein.

III. PARTIES & DEFINITIONS

• Company: [Company Legal Name] (“Company”)
• Service Provider: [Contractor/Vendor Legal Name] (“Provider”)
• Project Name: [Full Project Title]
• Base Agreement Date: [Date of Original Contract/SOW]

IV. OPERATIVE CLAUSES & TERMS

1. Scope of Change: The Provider shall perform the additional or modified tasks described in Exhibit A (Detailed Description of Change).
2. Impact Analysis:
   • Schedule: The project delivery date is [ ] Unchanged / [ ] Extended to YYYY-MM-DD.
   • Budget: The total financial impact of this change is [Amount in Currency], representing [ ] Increase / [ ] Decrease in total project fees.
   • Resource Allocation: Any changes to personnel, equipment, or facility requirements are attached in Exhibit B.
3. Acceptance: Upon completion of the tasks outlined in Exhibit A, the Company shall have [Number] business days to provide written notice of acceptance or rejection based on the agreed-upon Acceptance Criteria.
4. Integration: This PCR represents the entire agreement regarding the specific change herein and supersedes any prior oral or written communication regarding this specific modification. All other terms of the Base Agreement remain in full force and effect.
5. Severability: If any provision of this PCR is held to be unenforceable, the remaining provisions shall continue in full force and effect.

V. SIGNATURES & ACKNOWLEDGMENT

By signing below, the authorized representatives confirm their authority to bind their respective organizations to the terms of this Change Request.

For: [Company Name] Signature: __________________________ Printed Name: [Name] Title: [Title] Date: [YYYY-MM-DD]

For: [Service Provider Name] Signature: __________________________ Printed Name: [Name] Title: [Title] Date: [YYYY-MM-DD]

VI. EXECUTION GUIDE

1. Complete Exhibits: Attach Exhibit A (Technical/Operational requirements) and Exhibit B (Cost/Schedule breakdown) before circulation for signature.
2. Verify Authority: Ensure the signatories listed above hold the legal or operational mandate to commit the entity to financial and timeline variances.
3. Formal Ratification: Upon signature, scan and attach the executed PDF to the original project repository/contract management system.
4. Notice of Activation: Issue a formal "Notice to Proceed" (NTP) to the Provider’s project lead immediately upon receipt of the fully executed document.