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Revised 04/23 <br /> <br />ORANGE COUNTY <br /> CHANGE ORDER REQUEST <br />NORTH CAROLINA <br /> <br />______________________________________________________________________________________________________________ <br />Date: 7/17/2023 Project: Southern Human Services HVAC Controls Change Order No. 03 Department: AMS <br /> Department Address: 306 Revere Road, Hillsborough NC 27278 Project: Southern Human Services HVAC Controls Contractor: <br />Siemens Industry, Inc. Contractor Address: 215 Southport Drive, Suite 900, Morrisville, NC 27560 Effective date of original contract: 06/21/2021 <br /> <br />This change order increases decreases the contract time by 547 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 completion is: <br />December 29, 2023 <br />_______________________________________________________________________________________________________________ <br /> <br />Full Description of Change: This change is to add furnishing and installing all devices and programming to control the equipment per the sequence of <br />operation for the additional equipment found in the field that was not shown on the original plans and specifications. This also includes providing <br />commissioning support services that were not included as a part of the original contract. <br /> <br />Reason for Change: This change is for field-identified equipment to be added to the scope of work for items not shown on the plans and specifications <br />including commissioning support. The substantial completion date has been extended so many days due to the lead time of the Roof Top HVAC Units. <br />_______________________________________________________________________________________________________________ <br /> <br />Original contract sum: $ 203,450.00 <br /> <br />Contract sum prior to this change order: $ 215,847.90 <br /> <br />Amount of this change order: $ 32,472.72 <br /> <br />Total sum of the contract including this change order: $ 248,320.62 <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, project, services, or <br />work in any other manner. All other terms of the Original Contract remain in effect. <br />Approved and executed this 20th day of July, 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: DB053680-38C3-450E-AF31-FC6CE9F0C665 <br />7/18/2023 <br />Branch General Manager County Manager <br />7/21/2023