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<br />- 25 - <br />EXHIBIT A <br /> <br />CHANGE ORDER FORM <br /> <br />This Change Order Number ___ is made as of _____________ in reference to that certain Statement of <br />Work No. ___ entered into by and between Farragut Systems, Inc. (“Farragut”) and _______________ <br />(“Customer”) dated __________________, which is subject to the Master Services Agreement between <br />the parties. <br />For: <Change Order Title> <br /> <br />I. Change Request <br />Description of Proposed Change: <br />Business Reason for Proposed Change: <br />Change Request submitted by: ___ Customer ___ Farragut <br />Name: __________________________ Signature: _______________________ <br />Title: ___________________________ Date: ___________________________ <br /> <br />II. Analysis of Change <br />Fee Impact: <br />Change in Project Schedule: <br />Other Considerations: <br /> <br />III. Approval or Denial <br />If not approved by both parties within 10 days of submission, this change request will be deemed <br />denied. <br />Approved: ___ <br />Denied: ___ <br /> <br /> <br />Farragut Systems, Inc. <br /> <br />By: ______________________________ <br />Name: ____________________________ <br />Title: _____________________________ <br />Date: _____________________________ <br /> <br />Customer: _________________________ <br /> <br />By: _______________________________ <br />Name: _____________________________ <br />Title: ______________________________ <br />Date: _____________________________ <br /> <br />DocuSign Envelope ID: 7DCC2B8A-E44C-4172-BF52-8A8B6D647BED