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� ���� ii�.�Zav.� <br /> � a��`\O" � \ . <br /> � ��� <br /> 6 ��..::a�^i., y����J <br /> � i h � � �ti������ � � <br /> \ <br /> .���������..`��\f,a�.���,���� ;� � \ ' 4�'� ,�»: � , <br /> S .��-:a''� �,�� � ,�.�� �.� <br /> Appendix C — Project Change Control Document <br /> Customer Name: <br /> Burwood Project#: <br /> Re uest com leted b re uester <br /> Author: <br /> Date of Request: <br /> Change# <br /> Title of Change: <br /> Description of Change: <br /> Reason for Change: <br /> Hardware Required: <br /> Software Required: <br /> Action Required: <br /> Target completion date: <br /> Change Requested by: <br /> (Signature) <br /> Im act com leted b Pro'ect Mana er <br /> Timeline Impact: <br /> Cost Impact: <br /> Overall I mpact: <br /> PM Approval ( ) YES ( ) NO (Tick As Appropriate) <br /> Recommendation: <br /> PM Comments: <br /> Project Manager: <br /> (Signature) <br /> InstrucUons:The Request portion of this form is to be completely filled out by the requester and delivered to the Project Manager.The Project <br /> Manager will research the impact on the projec[timeline as well as any cost or resource impact and complete the Impact portion of this form The <br /> approval authority for the project will then sign the Approval portion before any work can take place and retum the form to the Project Manager for <br /> action.The Project Manager will take appropriate action to implement Ihe approved Change Reques[,document the change in the Work Record <br /> portion of this form,and make any required adjus[ments to the timeline and financials.This completed form will be retained as part of Ihe permanent <br /> project file. <br /> fl �i �� i��t"��i ���<<. � <br /> burwood , ,.� „,.��F.- -- .: : � <br /> gfOUp, ItIC. f Page 7 of 8 <br /> Confidential and Proprietary to Bunvood Group,Inc. <br />