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DocuSign Envelope ID:EEC95C86-425F-4B19-8B7B-D793E7A74AE5 <br /> ORANGECOUNTY <br /> CHANGE ORDER REQUEST <br /> NORTH CAROLINA <br /> Date:9/24/2018 Project: Passmore Center Expansion Change Order No. 1 Department:AMS <br /> Department Address: 131 W.Margaret Lane, Hillsborough,NC 27278 Project: Passmore Center Expansion <br /> Contractor: H.M.Kern Contractor Address:160 Thatcher Road,Greensboro,NC 27419 Effective date of original contract: <br /> 1/23/2018 <br /> This change order❑ increases❑decreases the contract time by days. Check here if no impact to contract time Z. <br /> Will this change order impact the date of substantial completion?❑ Yes❑ No. If yes,the amended date of substantial <br /> completion is: October 15,2018 <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: $494,820.00 <br /> Amount of this change order: $15,138.00 <br /> Total sum of the contract including this change order: $509,958.00 <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 /> Aoogoved and executed this 24th day of September,.2018. <br /> ON-N <br /> lvEhv. 3/20/2019 E�aw'+t}}0'w'Ht, 3/26/2019 3/20/2019 <br /> Contractor Owner Architect(when retained) <br /> By:project Manager gy:county Manager By: Associate <br /> Revised 10/17 <br />