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Revised 04/23 <br />ORANGE COUNTY <br />CHANGE ORDER REQUEST <br />NORTH CAROLINA <br />______________________________________________________________________________________________________________ <br />Date: 03/18/2024 Project: Efland EMS & ME Review Quarters Change Order No. 02 Department: AMS/ES Department <br />Address: 306 Revere Road, Hillsborough NC 27278 Project: Efland EMS & ME Review Quarters Contractor: Siemens Industry, Inc. <br />Contractor Address: 215 Southport Drive, Ste 900, Morrisville, NC 27560 Effective date of original contract: 05/05/2022 <br />This change order increases decreases the contract time by 437 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 />December 20, 2024 <br />_______________________________________________________________________________________________________________ <br />Full Description of Change: Additional labor hours to cover for delays in construction. <br />Reason for Change: The additional changes are due to the delays in the construction by the General Contractor for this project. <br />_______________________________________________________________________________________________________________ <br />Original contract sum: $ 80,000.00 <br />Contract sum prior to this change order: $ 98,677.18 <br />Amount of this change order: $ 23,791.10 <br />Total sum of the contract including this change order: $ 122,468.28 <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 18th day of March, 2024. <br />_______________________________ _____________________________ _____________________________ <br />Contractor Owner Architect (when retained) <br />By:____________________________ By:___________________________ By:___________________________ <br />DocuSign Envelope ID: F1274CE7-87E2-472B-80D7-92EE123F3A5E <br />Branch General Manager <br />3/12/2024 <br />County Manager <br />3/17/2024