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Exhibit A : <br /> Project Change Request ( PCR) Form <br /> GENERAL • _ • <br /> PCR Number: Financial Approval <br /> Create Date : Approval Date : <br /> PCR Title : <br /> Agreement/SOW Title : <br /> Customer or Name : Email : Phone : <br /> Vendor Name : <br /> Change Initiator : Name : Email : Phone : <br /> ( prepared by) <br /> SCOPE OF CHANGE <br /> Reason for (Include description of existing state) <br /> Change : <br /> Description of <br /> Desired Change : <br /> Effect of (Include description of impact if implemented and if NOT implemented) <br /> Change : <br /> In the fields below, identify impact to Budget, Schedule, Quality, Quantity, <br /> Resources, and Cost; insert n/a if not applicable <br /> Budget : Schedule : Quality : <br /> Quantity : Resources : Cost : <br /> Cost to be paid by : <br /> SIGNATURE <br /> Upon signatures by both parties the Agreement and SOW identified above shall be amended as <br /> described herein . <br /> For Lenovo Customer <br /> Signature Signature : <br /> Printed Name : Printed Name : <br /> Title : Title : <br /> Date : Date : <br /> 1 <br /> Lenovo ( United States ) Inc . <br /> Statement of Work for Orange County , NC <br /> CLM # 164807 <br />