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i <br /> DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 <br /> I <br /> CHANGE ORDER Request Form <br /> Number 001 <br /> PROJECT: Efiand Sewer to Mebane Phase 2 DATE OF ISSUANCE: <br /> Extension <br /> OWNER'S PROJECT NO.: <br /> OWNER: Orange County, North Carolina ENGINEER: McGill Associates, P.A, <br /> 1240 19t"St. Ln.NW <br /> CONTRACTOR: J �- l4f J /A- 'f P 3 4A-7 /-00 �, CO, Hickory, NC 28601 <br /> i <br /> CONTRACT FOR: ENGINEER'S PROJECT NO.: 16.01904 <br /> You are directed to make the following changes in the Contract Documents. <br /> Description: 'V e 12 fe z r/rs, fit°�� 1 t �' Ur l ve <br /> Purpose of Change Order: 0 w j4 e p-S �{'�u e <br /> Attachments(List documents supporting change): � 1� �� !�Q• � �eS � Z�7 ��'� 6,10 <br /> CHANGE IN CONTRACT PRICE: CHANGE IN CONTRACT TIME: <br /> Original Contract Price Original Contract Time <br /> 365 Days <br /> Previous Change Order No._to No._ Net Change From Previous Change Orders <br /> $ Days <br /> Contract Price Prior to This Change Order Contract Time Prior to This•Change Order <br /> $ 33�,V� 1 z 1, G 0 3G 5T Days <br /> Net Increase(Decrease)of This Change Order Net Increase(Decrease)of This Change Order <br /> �r- <br /> $ <br /> Days <br /> Contract Price With All Approved Change Orders Contract Time With All Approved Change Orders <br /> $ 3�77 q�Z 1, 00 3�5~Days <br /> nnri,Ainnd hy: <br /> RECOMMENDED: APPROVED: APPROVED: At, A l wsov' <br /> n,ri,P.i�nnd hy: by'UocuSlgneO <br /> By.-Z� <br /> "CRtlli1/YL'31]OdL 1�C 1:CMC FC1C2.. <br /> Im't m Associates Orange County <br /> (Engineer) (Owner) (Contractor) <br /> 12/14/2018 12/17/2018 12/14/2018 <br /> EJCDC No.1910$-8(1983 Edition) <br /> ICOR 001 <br /> Prepared by the Engineers'Joint Contract Documents committee and endorsed by The Associated General Contractors of America_ <br />