Change Request Form Project Management Example

FORMAL PROJECT CHANGE REQUEST FORM & AUTHORIZATION AGREEMENT

DOCUMENT CONTROL

• Effective Date: [Effective Date]
• Document Version: [Version Number, e.g., 2.0]
• Jurisdiction / Scope: [Governing State/Country & Project Scope Identifier]
• Master Agreement Reference: [Date and Title of Underlying Master Services Agreement / Statement of Work]

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1. LEGAL NOTICE & COMPLIANCE DISCLAIMER

This document constitutes a formal operational and legal modification mechanism pursuant to the terms of the governing agreement between the parties. Submission of this Change Request Form does not bind either party until fully executed by authorized representatives of both [Company Name] ("Client") and [Provider/Vendor Name] ("Service Provider"). Unauthorized alterations to the operative clauses of this form are legally void. All modifications herein are subject to the pricing, scheduling, and scope provisions set forth in the Master Services Agreement.

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2. PARTIES & DEFINITIONS

• Client: [Client Full Legal Name], a [State of Incorporation] [Entity Type, e.g., Corporation / LLC], with its principal place of business at [Client Physical Address] ("Client").
• Service Provider: [Provider Full Legal Name], a [State of Incorporation] [Entity Type, e.g., Corporation / LLC], with its principal place of business at [Provider Physical Address] ("Provider").
• Project Name: [Official Project Name] ("Project").
• Change Request Identification: CR Number: [CR-00X]

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3. OPERATIVE CLAUSES & TERMS

3.1 Purpose and Scope of Modification

This Change Request ("CR") defines the modification to the baseline scope of work, schedule, or financial compensation for the Project. Upon mutual execution, this document amends the operative Statement of Work ("SOW") dated [Original SOW Date] in accordance with the change management procedures of the governing agreement.

3.2 Description of Requested Change

• Detailed Specification of Change: [Provide a comprehensive, clinical description of the modifications, additions, or deletions to the Project deliverables, system architecture, or operational workflows. Avoid vague language.]
• Justification and Business Rationale: [Detail the operational, technical, or business driver necessitating this modification.]

3.3 Impact Analysis (Schedule, Cost, and Resources)

The parties acknowledge and agree that the modifications detailed in Section 3.2 shall have the following quantifiable impacts upon the Project baseline:

• Schedule Impact:
  • Current Scheduled Completion Date: [Current Completion Date]
  • Proposed Revised Completion Date: [Revised Completion Date or "No change"]
  • Net Timeline Variance: [Number] Business Days / Calendar Days
• Financial Impact:
  • Original Baseline Project Budget: [$0,000.00]
  • Net Cost Adjustment of this CR: [+$0,000.00 (Addition) / -$0,000.00 (Reduction)]
  • Total Revised Project Budget: [$0,000.00]
• Payment Milestone Adjustments: [Detail any modified or newly created billing milestones, net payment terms, or deposit requirements triggered by this CR.]
• Resource & Technical Dependencies: [List any hardware, software, third-party licenses, or Client-furnished resources required to implement this change.]

3.4 Risk Assessment & Mitigation

• Identified Operational/Technical Risks: [Outline specific risks associated with implementing this change, such as integration latency, downtime, or resource contention.]
• Mitigation Strategy: [Detail the operational safeguards implemented by Provider to mitigate the risks identified above.]

3.5 Acceptance Criteria

The deliverables or modified functionalities described in this CR shall be deemed accepted by Client upon successful completion of the acceptance testing protocols set forth in Section [Section Number] of the Master Services Agreement, or upon execution of a formal Certificate of Acceptance.

3.6 Integration and Supremacy

Except as expressly modified by this Change Request, all terms, conditions, warranties, and covenants of the underlying Master Services Agreement and associated SOW shall remain in full force and effect. In the event of any direct conflict between the terms of this CR and the underlying SOW, the terms of this CR shall govern exclusively with respect to the subject matter contained herein.

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4. SIGNATURES & ACKNOWLEDGMENT BLOCK

IN WITNESS WHEREOF, the parties hereto have caused this Project Change Request Form to be duly executed by their respective authorized officers or operational representatives.

CLIENT: [Client Legal Name]

Signature: ___________________________________________

Printed Name: [Authorized Representative Name]

Title: [Authorized Representative Title, e.g., Chief Executive Officer]

Date: [Date of Execution]

SERVICE PROVIDER: [Provider Legal Name]

Signature: ___________________________________________

Printed Name: [Authorized Representative Name]

Title: [Authorized Representative Title, e.g., VP of Operations]

Date: [Date of Execution]

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5. STEP-BY-STEP EXECUTION GUIDE

1. Drafting and Impact Assessment: The Project Manager requesting the modification must complete Sections 2, 3.1, 3.2, 3.3, and 3.4 in consultation with technical leads to ensure precise cost and schedule estimates. Unverified estimates are strictly prohibited.
2. Legal and Operational Review: Both Client and Provider project sponsors must review the financial and timeline impacts to ensure alignment with budgetary constraints and resource availability.
3. Formal Execution: Secure physical or cryptographically verified digital signatures (e.g., DocuSign, Adobe Sign) from the authorized signatories listed in Section 4 prior to initiating any operational work associated with the change.
4. Archival and Baseline Update: Attach the fully executed Change Request Form to the master project repository and update the official Project Schedule Baseline (WBS) accordingly. Work commenced prior to full execution is performed at the sole risk of the performing party.