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DocuSign Envelope ID:5C8F1523-AE23-4D8E-9C19-C2404873B86F <br /> ORANGECOUNTY <br /> CHANGE ORDER REQUEST <br /> NORTH CAROLINA <br /> Date: 12-21-18 Project:Passmore Center Expansion Change Order No.2 Department:AMS Department <br /> Address:131 W.Margaret Lane,Hillsborough,NC 27278 Project: Passmore Center Expansion Contractor: H.M.Kern <br /> Contractor Address:160 Thatcher Road,Greensboro,NC 27419 Effective date of original contract: 1/23/2018 <br /> This change order® increases❑decreases the contract time by 90 days. Check here if no impact to contract time❑. <br /> Will this change order impact the date of substantial completion?® Yes❑ No. If yes,the amended date of substantial <br /> completion is: February 10,2019 <br /> Full Description of Change:This change order is to increase the original contract value to include items that were changes to the scope of <br /> work,or adds per the tentants.See the attached project description of changes for full details. <br /> Reason for Change: See the attached project description of changes for full details. <br /> Original contract sum: $494,820.00 <br /> Contract sum prior to this change order: $509,958.00 <br /> Amount of this change order: $4,119.00 <br /> Total sum of the contract including this change order: $514,077.00 <br /> This change order is executed to amend the contract time and/or contract sum. It shall not be construed to impact the original contract, <br /> project,services,or work in any other manner. <br /> A�nngovPd and executed this 21st day of December,2011L8. aq.,, <br /> jv�hv'�i�L: �rL 1A 4v.N } I. 3/21/2019 12/21/2018 <br /> Contractor Owrier Architect(when retained) <br /> By:12/21/2018 By: county Manager By: Associate <br /> Revised 10/17 <br />