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Revised 06/21 <br /> <br />ORANGE COUNTY <br /> CHANGE ORDER REQUEST <br />NORTH CAROLINA <br /> <br />______________________________________________________________________________________________________________ <br />Date: 11/17/2021 Project: 401 Valley Forge Rd, Hillsborough NC Change Order No. 2 Department: AMS <br /> Department Address: PO Box 8181, Hillsborough NC Project: Builders Source Contractor: Kennon Craver <br /> Contractor Address: 4011 University Drive Effective date of original contract: 02/12/2021 <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: Second Amendment to Engagement to include and are limited to advising the County on property disposition <br />and closing matter for the sale of 401 Valley Forge Rd <br /> <br />Reason for Change: Additional Scope <br />_______________________________________________________________________________________________________________ <br /> <br />Original contract sum: $ 5000.00 <br /> <br />Contract sum prior to this change order: $ 15000.00 <br /> <br />Amount of this change order: $ 20000.00 <br /> <br />Total sum of the contract including this change order: $ 35000.00 <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 17th day of November, 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: 10B000F8-82AD-4513-AF53-EED6DBB01232 <br />11/17/2021 11/22/2021