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Revised 06/21 <br />ORANGE COUNTY <br />CHANGE ORDER REQUEST <br />NORTH CAROLINA <br />______________________________________________________________________________________________________________ <br />Date: 1/3/2023 Project: WCOB 3rd Floor Renovations Change Order No. 4 Department: AMS Department <br />Address: PO Box 8181, Hillsborough NC 27278 Project: West Campus 3rd Floor Renovation Contractor: HH Architecture <br />Contractor Address: 1100 Dresser Court, Raleigh NC 27609 Effective date of original contract: 01/05/2022 <br />This change order increases decreases the contract time by 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: <br />_______________________________________________________________________________________________________________ <br />Full Description of Change: WCOB 3rd Floor Renovation-Amendment# 4 <br />Reason for Change: Additional Professional Design Services for WCOB 3rd floor Renovation project. <br />_______________________________________________________________________________________________________________ <br />Original contract sum: $ 42900.00 <br />Contract sum prior to this change order: $ 45500.00 <br />Amount of this change order: $ 500.00 <br />Total sum of the contract including this change order: $ 46000.00 <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 3rd day of January, 2023. <br />_______________________________ _____________________________ _____________________________ <br />Contractor Owner Architect (when retained) <br />By:____________________________ By:___________________________ By:___________________________ <br />DocuSign Envelope ID: C05A3CC5-F788-4E51-B35C-E2C53B886A5E <br />1/3/20231/6/2023