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Revised 04/23 <br />ORANGE COUNTY <br />CHANGE ORDER REQUEST <br />NORTH CAROLINA <br />______________________________________________________________________________________________________________ <br />Date: 1/26/2024 Project: MOTORPOOL SHOP ROOM RENOVATION Change Order No. 1 Department: AMS <br />Department Address: 306 REVERE RD. HILLSBOROUGH, NC 27278 Project: MOTORPOOL Contractor: FA JENKINS Contractor <br />Address: 402 AVALON DR. MEBANE, NC 27302 Effective date of original contract: 10/03/2023 <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: INSTALL NEW EPOXY FLOORING IN BREAK ROOM AREA <br />Reason for Change: FLOORS NEED TO BE REDONE DUE TO RENOVATION <br />_______________________________________________________________________________________________________________ <br />Original contract sum: $ 35,950.00 <br />Contract sum prior to this change order: $ 35,950.00 <br />Amount of this change order: $ 4,200.00 <br />Total sum of the contract including this change order: $ 40,150.00 <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, project, services, or <br />work in any other manner. All other terms of the Original Contract remain in effect. <br />Approved and executed this 26TH day of JANUARY, 2024. <br />_______________________________ _____________________________ _____________________________ <br />Contractor Owner Architect (when retained) <br />By:____________________________ By:___________________________ By:___________________________ <br />DocuSign Envelope ID: 1EEF8CF7-3E75-4B10-ACA9-4C9E6F69423C <br />2/5/2024 2/13/2024