HomeMy WebLinkAbout2021-547-E-AMS-Intellicom-Bonnie B-change exchange upgrade AV equipmentRevised 06/21
ORANGE COUNTY
CHANGE ORDER REQUEST
NORTH CAROLINA
______________________________________________________________________________________________________________
Date: 10/01/2021 Project: Northern Campus AV Change Order No. 01 Department: AMS Department
Address: PO Box 8181, Hillsborough NC 27278 Project: Northern Campus AV- Bonnie B Building Contractor: Intellicom Inc
Contractor Address: 3252 S Miami Blvd, Suite 145, Durham NC 27703 Effective date of original contract: 05/14/2021
This change order increases decreases the contract time by days. Check here if no impact to contract time .
Will this change order impact the date of substantial completion? Yes No. If yes, the amended date of substantial
completion is:
_______________________________________________________________________________________________________________
Full Description of Change: Display Exchanges & Additions to the Lobby, Multipurpose room, and Meeting room at the Bonnie B Davis
Building
Reason for Change: Adding/ upgrading displays
_______________________________________________________________________________________________________________
Original contract sum: $ 74715.13
Contract sum prior to this change order: $ 74715.13
Amount of this change order: $ 5024.48
Total sum of the contract including this change order: $ 79,739.61
_______________________________________________________________________________________________________________
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 work in any other manner. All other terms of the Original Contract remain in effect.
Approved and executed this 1st day of October, 2021.
_______________________________ _____________________________ _____________________________
Contractor Owner Architect (when retained)
By:____________________________ By:___________________________ By:___________________________
DocuSign Envelope ID: D363377F-937A-4ADD-BABA-65C5565679B8
10/5/2021 10/7/2021
Revised 06/21
DocuSign Envelope ID: D363377F-937A-4ADD-BABA-65C5565679B8
Revised 06/21
ORANGE COUNTY—DEPARTMENT USE ONLY
_____________________________________________________________________________________________________
Party/Vendor Name: Intellicom Inc Party/Vendor Contact Person: Mike Bullock Contact Phone: 919-957-1949 Party/Vendor Address: 3252 S Miami
Blvd Suite 145 City Durham State: NC Zip: 27703 Department: AMS Amount: $5024.48 Purpose: Bonnie B-Change/exchange/upgrade AV equipment
Budget Code(s): 61370035-800111-10064 Vendor # 44533 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check
one) New Renewal Amendment Effective Date Approved by Board Yes No Agenda Date: --- For Section XIV. c.
contracts only, Approved by Board in Current FY Budget Yes No
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated
prior to execution of the agreement:
Department Director’s Signature ________________________________________ Date: ________
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been
completed please briefly describe the nature of the emergency condition that was addressed:
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board __________________________________________Date:_________
DocuSign Envelope ID: D363377F-937A-4ADD-BABA-65C5565679B8
10/4/2021
10/5/2021
10/6/2021
10/7/2021
DocuSign Envelope ID: D363377F-937A-4ADD-BABA-65C5565679B8
DocuSign Envelope ID: D363377F-937A-4ADD-BABA-65C5565679B8
DocuSign Envelope ID: D363377F-937A-4ADD-BABA-65C5565679B8