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Revised 06/21 <br /> <br />ORANGE COUNTY <br /> CHANGE ORDER REQUEST <br />NORTH CAROLINA <br /> <br />______________________________________________________________________________________________________________ <br />Date: 10/01/2021 Project: Northern Campus AV Change Order No. 01 Department: AMS Department <br />Address: PO Box 8181, Hillsborough NC 27278 Project: Northern Campus AV- Bonnie B Building Contractor: Intellicom Inc <br /> Contractor Address: 3252 S Miami Blvd, Suite 145, Durham NC 27703 Effective date of original contract: 05/14/2021 <br /> <br />This change order increases decreases the contract time by days. Check here if no impact to contract time . <br /> <br />Will this change order impact the date of substantial completion? Yes No. If yes, the amended date of substantial <br />completion is: <br />_______________________________________________________________________________________________________________ <br /> <br />Full Description of Change: Display Exchanges & Additions to the Lobby, Multipurpose room, and Meeting room at the Bonnie B Davis <br />Building <br /> <br />Reason for Change: Adding/ upgrading displays <br />_______________________________________________________________________________________________________________ <br /> <br />Original contract sum: $ 74715.13 <br /> <br />Contract sum prior to this change order: $ 74715.13 <br /> <br />Amount of this change order: $ 5024.48 <br /> <br />Total sum of the contract including this change order: $ 79,739.61 <br /> <br />_______________________________________________________________________________________________________________ <br />This change order is executed to amend the contract time or contract sum. It shall not be construed to impact the original contract, <br />project, services, or work in any other manner. All other terms of the Original Contract remain in effect. <br />Approved and executed this 1st day of October, 2021. <br />_______________________________ _____________________________ _____________________________ <br />Contractor Owner Architect (when retained) <br /> <br />By:____________________________ By:___________________________ By:___________________________ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />DocuSign Envelope ID: D363377F-937A-4ADD-BABA-65C5565679B8 <br />10/5/2021 10/7/2021