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Revised 04/23 <br />ORANGE COUNTY <br />CHANGE ORDER REQUEST <br />NORTH CAROLINA <br />______________________________________________________________________________________________________________ <br />Date: 10/16/2024 Project: Efland EMS & ME Review Quarters Change Order No. 04 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 507 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: February <br />28, 2025 <br />_______________________________________________________________________________________________________________ <br />Full Description of Change: Run 24V Wiring from the FA Panel to bell. Remove and reinstall devices for wires to pass through muliple boxes, install relays <br />to bay fans. <br />Reason for Change: These changes are due to code updates, missing scope from sprinkler contractor, and changes in the field. <br />_______________________________________________________________________________________________________________ <br />Original contract sum: $ 80,000.00 <br />Contract sum prior to this change order: $ 129,868.28 <br />Amount of this change order: $ 6,671.70 <br />Total sum of the contract including this change order: $ 136,539.98 <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 25th day of January, 2025. <br />_______________________________ _____________________________ _____________________________ <br />Contractor Owner Architect (when retained) <br />By:____________________________ By:___________________________ By:___________________________ <br />Docusign Envelope ID: ED6DD193-F61D-4B41-93F2-0D70F897D0E2 <br />Budget Analyst IIBudget Analyst II <br />1/23/20251/28/2025