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Revised 06/21 <br /> <br />ORANGE COUNTY <br /> CHANGE ORDER REQUEST <br />NORTH CAROLINA <br /> <br />______________________________________________________________________________________________________________ <br />Date: 01/26/2023 Project: OCPT Admin Fire Alarm System Change Order No. 01 Department: AMS <br /> Department Address: 306 Revere Road Project: OCPT Admin Bldg Fire Alarm System Contractor: Siemens Industry, <br />Inc. Contractor Address: 215 Southport Drive, Ste 900 Effective date of original contract: 5/16/2022 <br /> <br />This change order increases decreases the contract time by 48 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: March 13, 2023 <br />_______________________________________________________________________________________________________________ <br /> <br />Full Description of Change: Add power for new FACP Panel <br /> <br />Reason for Change: This was originally excluded from the contract. This change is to add this back into the contract. <br />_______________________________________________________________________________________________________________ <br /> <br />Original contract sum: $ 41,206.00 <br /> <br />Contract sum prior to this change order: $ 41,206.00 <br /> <br />Amount of this change order: $ 909.00 <br /> <br />Total sum of the contract including this change order: $ 42,115.00 <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 28th day of January, 2023. <br />_______________________________ _____________________________ _____________________________ <br />Contractor Owner Architect (when retained) <br /> <br />By:____________________________ By:___________________________ By:___________________________ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />DocuSign Envelope ID: 090A9D1C-0F59-42BA-BA43-AB22DEC4ECCA <br />1/26/2023 <br />Branch General Manager <br />1/27/2023 <br />County Manager