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Revised 04/23 <br />ORANGE COUNTY <br />CHANGE ORDER REQUEST <br />NORTH CAROLINA <br />______________________________________________________________________________________________________________ <br />Date: 11/21/2023 Project: Passmore Center Fire Alarm Replacement Change Order No. 03 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 />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 completion is: <br />_______________________________________________________________________________________________________________ <br />Full Description of Change: Provide additional site visits for interactions with existing panel, and existing panel fire alarm contractor. Provide <br />programming, engineering, and relays for door releases at the Adult Day Center. <br />Reason for Change: Additional services are required due to the age and inability of the existing panel contractor to provide services as requested. <br />Previously due to services provided at the adult day the FM did not require the doors to be released, however, due to changes the FM is requiring the <br />doors and gates to release. <br />_______________________________________________________________________________________________________________ <br />Original contract sum: $ 121,514.00 <br />Contract sum prior to this change order: $ 158,183.88 <br />Amount of this change order: $ 17,568.97 <br />Total sum of the contract including this change order: $ 175,752.85 <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 27th day of November, 2023. <br />_______________________________ _____________________________ _____________________________ <br />Contractor Owner Architect (when retained) <br />By:____________________________ By:___________________________ By:___________________________ <br />DocuSign Envelope ID: FF68AEDC-6252-4FCC-B7E7-EB41C9214613 <br />Branch General Manager <br />11/22/2023 <br />County Manager <br />11/24/2023