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Revised 04/23 <br /> <br />ORANGE COUNTY <br /> CHANGE ORDER REQUEST <br />NORTH CAROLINA <br /> <br />______________________________________________________________________________________________________________ <br />Date: 9/20/2023 Project: Passmore Center Fire Alarm Replacement Change Order No. 01 Department: AMS <br /> Department Address: 306 Revere Road, Hillsborough NC 27278 Project: Passmore Center Fire Alarm Replacement Contractor: <br />Siemens Industry, Inc. Contractor Address: 215 Southport Drive, Morrisville, NC 27560 Effective date of original contract: 4/7/2023 <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 completion is: <br />_______________________________________________________________________________________________________________ <br /> <br />Full Description of Change: Provide monitoring services for FA system. <br /> <br />Reason for Change: Add monitoring servies.. <br />_______________________________________________________________________________________________________________ <br /> <br />Original contract sum: $ 121,514.00 <br /> <br />Contract sum prior to this change order: $ 121,514.00 <br /> <br />Amount of this change order: $ 5,400.00 <br /> <br />Total sum of the contract including this change order: $ 126,914.00 <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, 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 September, 2023. <br />_______________________________ _____________________________ _____________________________ <br />Contractor Owner Architect (when retained) <br /> <br />By:____________________________ By:___________________________ By:___________________________ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />DocuSign Envelope ID: 3726CF6A-D950-4791-97D4-378DEA7FA227 <br />9/15/2023 <br />Branch General Manager County Manager <br />9/18/2023