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JUUNIFIED <br />TECHNOLOGIES1000181 <br />Appendix B: Project Change Request Form <br />The following Project Change Request form is to be used as described in the SOW. <br />Project Name: <br />Change Number: <br />Change Name:. <br />Date of Request: <br />Requested By: <br />Priority: <br />❑ High ❑ Med ❑ Low <br />teasor for the Regdest: <br />Description of Requested Change: <br />mpact on Organization / Effect'of NOT Approving this Change: <br />Cost of Change: <br />Item Description <br />Hours (if hourly) <br />Reduction/Increase <br />Dollars <br />Reduction/Increase <br />Total Net Change in Hours/Cost: <br />Client Approval: <br />R2 Project Manager: <br />Signature: <br />Title: <br />Signature: <br />Title: <br />Date: <br />Date: <br />Statement of Work page 40 of 40 <br />