Sample (National Capital Area) Program Change Approval Process Form

Sample (National Capital Area) Program Change Approval Process Form (Word, 183KB)

Client Service Team (CST)
Responsibility Centre (RC)#
Project Name
Project No.
Sub-Project No.

Change Request Description

Requester's Name:

Impact Analysis

Cost Impact

Note: This table is only for example and contains no data.

  Estimate ($)
Consultant $
Construction $
A&ES $

Time Impact

Time (Number of Days)—Estimate
Can delay be recuperated? Yes or No
If yes: Description of recuperation

Departmental Representative's Recommendation

Date:

Project Leader's Approval

Cost Impact

Yes or No

Time Impact

Yes or No

Project Leader Acceptance

Name:
Date:

Proposal Cost Sharing

Note: This table is only for example and contains no data.

  Coding Amount (dollars)
End Users   $
PSPC   $
  Total $

Comments

Departmental Representative

Senior Project Manager

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