Agilant Solutions, Inc. Scope of Work Security Assessment Services Agilant Solutions, Inc. Page 9 of 13 9.1 Sample Change Request/Change Control Form Chicago Flooring Company Inc Requestor Date Nature of Change Requests and Rationale Investigation Charges Authorized Client Signature Date Agilant Signature Date Investigation results and impact to project Project Price Modification Accept/Reject Change Accept Reject Authorized Client Signature Date Agilant Signature Date