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Home My WebLink About2023-115-E-AMS-Siemens Industry-Southern Human Services Fire Alarm System Replace (3) Duct DetectorsRevised 06/21 ORANGE COUNTY CHANGE ORDER REQUEST NORTH CAROLINA ______________________________________________________________________________________________________________ Date: 03/08/2023 Project: Southern Human Services Fire Alarm Replacement Change Order No. 01 Department: AMS Department Address: 306 Revere Road Project: Southern Human Services Fire Alarm Replacement Contractor: Siemens Industry, Inc. Contractor Address: 215 Southport Drive, Ste 900 Effective date of original contract: 10/7/2022 This change order increases decreases the contract time by 00 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: Provide and install (3) duct detectors and housings. Reason for Change: These duct detectors were not called out for on the plans and were found in the field after work started. This work is in direct relation to the new roof top units being installed at this time. _______________________________________________________________________________________________________________ Original contract sum: $ 121,514.00 Contract sum prior to this change order: $ 121,514.00 Amount of this change order: $ 5,605.69 Total sum of the contract including this change order: $ 127,119.69 _______________________________________________________________________________________________________________ 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 10th day of March, 2023. _______________________________ _____________________________ _____________________________ Contractor Owner Architect (when retained) By:____________________________ By:___________________________ By:___________________________ DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D 3/13/2023 Branch General Manager 3/14/2023 County Manager Revised 06/21 DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D Revised 06/21 ORANGE COUNTY—DEPARTMENT USE ONLY _____________________________________________________________________________________________________ Party/Vendor Name: Siemens Industry, Inc. Party/Vendor Contact Person: Antony Tejada-Puella (antony.tejada-puello@siemens.com) Contact Phone: 919.469.5095 Party/Vendor Address: 215 Southport Drive, Ste 900 City Morrisville State: NC Zip: 27560 Department: AMS Amount: $5,605.69 Purpose: Southern Human Services Fire Alarm System Replace (3) Duct Detectors Budget Code(s): 61370035-880000-30001 Vendor # 53325 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 03/10/2023 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: N/A 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: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D 3/13/2023 3/14/2023 3/14/2023 DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D DocuSign Envelope ID: 041974F1-A4A5-4EA3-AA14-DE7F9A08745D