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Home My WebLink About2023-329-E-AMS- Siemens Industry-SHSC - Add devices found in the field to SOW add commissioning supportRevised 04/23 ORANGE COUNTY CHANGE ORDER REQUEST NORTH CAROLINA ______________________________________________________________________________________________________________ Date: 7/17/2023 Project: Southern Human Services HVAC Controls Change Order No. 03 Department: AMS Department Address: 306 Revere Road, Hillsborough NC 27278 Project: Southern Human Services HVAC Controls Contractor: Siemens Industry, Inc. Contractor Address: 215 Southport Drive, Suite 900, Morrisville, NC 27560 Effective date of original contract: 06/21/2021 This change order increases decreases the contract time by 547 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: December 29, 2023 _______________________________________________________________________________________________________________ Full Description of Change: This change is to add furnishing and installing all devices and programming to control the equipment per the sequence of operation for the additional equipment found in the field that was not shown on the original plans and specifications. This also includes providing commissioning support services that were not included as a part of the original contract. Reason for Change: This change is for field-identified equipment to be added to the scope of work for items not shown on the plans and specifications including commissioning support. The substantial completion date has been extended so many days due to the lead time of the Roof Top HVAC Units. _______________________________________________________________________________________________________________ Original contract sum: $ 203,450.00 Contract sum prior to this change order: $ 215,847.90 Amount of this change order: $ 32,472.72 Total sum of the contract including this change order: $ 248,320.62 _______________________________________________________________________________________________________________ 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 20th day of July, 2023. _______________________________ _____________________________ _____________________________ Contractor Owner Architect (when retained) By:____________________________ By:___________________________ By:___________________________ DocuSign Envelope ID: DB053680-38C3-450E-AF31-FC6CE9F0C665 7/18/2023 Branch General Manager County Manager 7/21/2023 Revised 04/23 DocuSign Envelope ID: DB053680-38C3-450E-AF31-FC6CE9F0C665 Revised 04/23 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Siemens Industry, Inc. Vendor Contact Person: Brian Session (brian.session@siemens.com) Phone: 919.469.5095 Address: 215 Southport Drive, Ste 900 City Morrisville State: NC Zip: 27560 Department: AMS Amount: $32,472.72 Purpose: SHSC - Add devices found in the field to SOW, add commissioning support Budget Code(s): 61370035-800000-30018 Vendor # 53325 Vendor Status with NCSOS: Active Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: 10/7/2022) (Most Recent Amendment 03/08/2023) Effective Date 06/21/2021 End Date 12/29/2023 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by AMS Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: 30018) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(#Sourcewell) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this pro ject has not been initiated prior to execution of the agreement. Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or rela ted services 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 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: Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: DB053680-38C3-450E-AF31-FC6CE9F0C665 7/18/2023 7/19/2023 7/20/2023 7/20/2023 Proposal Orange County Services No: Change Order 2 Date: 6/29/2023 Attention: Angel Barnes Project: Orange County Southern Human Services – BAS Changes for field clarification: We propose to furnish and install the following changes to the Siemens Building Automation System (BAS) in accordance with CR 2. Change Order 2: $ 23,872.08 – System engineering, installation, start-up, check-out, and documentation per project requirements. Provide programming and update graphics for all controlled equipment on the Desigo workstation. Scope of Work $23,872.08– Siemens to provide all devices and programming to control the following equipment per the sequences of operation: Exceptions Proposal Accepted: Siemens Industry, Inc. is authorized to proceed with the work as proposed. Proposal Submitted: Siemens Industry, Inc. Purchaser Seller Siemens Industry, Inc. By By Brian Session Title Title Project Manager Date Date 6/29/23 DocuSign Envelope ID: DB053680-38C3-450E-AF31-FC6CE9F0C665 Proposal Orange County Services No: Change Order 3 Date: 6/29/2023 Attention: Angel Barnes Project: Orange County Southern Human Services – BAS Changes for field clarification: We propose to furnish and install the following changes to the Siemens Building Automation System (BAS) in accordance with CR 3. Change Order 3: $ 8,600.64– Provide commissioning testing support. Scope of Work $8,600.64– Siemens to provide commissioning support. Exceptions Proposal Accepted: Siemens Industry, Inc. is authorized to proceed with the work as proposed. Proposal Submitted: Siemens Industry, Inc. Purchaser Seller Siemens Industry, Inc. By By Brian Session Title Title Project Manager Date Date 6/29/23 DocuSign Envelope ID: DB053680-38C3-450E-AF31-FC6CE9F0C665 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME: CONTACT (A/C, No): FAX E-MAIL ADDRESS: PRODUCER (A/C, No, Ext): PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT ER OTH- STATUTE PER LIMITS(MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) POLICY EFF POLICY NUMBERTYPE OF INSURANCELTR INSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 1,000,000 10/01/2023 N/A GLD1110114 X TWXJUB-7440L338-TIL-22 (OH) NYC-009196547-31 1,000,000 UB-8P79233A-22-51-R (AZ,MA,WI) X 25674 of Marsh USA LLC N X10/01/2022 10/01/2023 N/A N/A TC2J-CAP-7440L34A-TIL-22 B 10,000,000 1,000,000 X '''''''''''$500K LIMIT / $500K SIR''''''''''' 25658 Travelers Property Casualty Co. of America 1,000,000 X X 05/02/2023 4433 10/01/2022 10/01/2022 RE: JOB NO. N/A X 10/01/2022 PO BOX 8181 HILLSBOROUGH, NC 27278 ORANGE COUNTY SEE ATTACHED A B The Travelers Indemnity Company CN102147003-RAM--22/23 100,000 10/01/2023 2,000,000 C INCL 41343 1,000,000 RENTA 1,000,000 X UB-8P83929A-22-51-K (AOS) 445 SOUTH STREET MARSH USA, LLC. MORRISTOWN, NJ 07960-6454 1000 DEERFIELD PARKWAY SIEMENS INDUSTRY, INC. BUFFALO GROVE, IL 60089-4513 10/01/2022 ATTN: RISK MANAGEMENT NOC60 B ... 10/01/2023 10/01/2023 HDI Global Insurance Company DocuSign Envelope ID: DB053680-38C3-450E-AF31-FC6CE9F0C665 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: FORM TITLE: ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE Page of AGENCY CUSTOMER ID: LOC #: AGENCY CARRIER NAIC CODE POLICY NUMBER NAMED INSURED EFFECTIVE DATE: 22 UMBRELLA IS FOLLOW FORM OF PRIMARY SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS. Morristown RESPECT TO ALL WORK PERFORMED BY AND ON BEHALF OF THE NAMED INSURED, SIEMENS INDUSTRY, INC. FOR CERTIFICATE HOLDER UNDER CONTRACT. EXTENT THAT A CLAIM ARISES FROM THE NEGLIGENCE OF SIEMENS INDUSTRY, INC. OR ITS SUBCONTRACTORS WITH RESPECT TO ALL OPERATIONS OF THE INSURED BUT ONLY WITH WAIVER OF SUBROGATION IS EFFECTUAL WHERE REQUIRED BY WRITTEN CONTRACT. RE: JOB NO. N/A LIABILITY INSURANCE POLICIES AND THE COVERAGE AFFORDED THE ADDITIONAL INSURED UNDER THESE POLICIES SHALL BE PRIMARY AND NON-CONTRIBUTORY INSURANCE TO THE ORANGE COUNTY, ITS OFFICERS, OFFICIAL AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED UNDER THE ABOVE REFERENCED GENERAL LIABILITY AND AUTOMOBILE Certificate of Liability Insurance CN102147003 TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. MARSH USA, LLC. 1000 DEERFIELD PARKWAY SIEMENS INDUSTRY, INC. BUFFALO GROVE, IL 60089-4513 25 IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER UP DocuSign Envelope ID: DB053680-38C3-450E-AF31-FC6CE9F0C665 3/29/23, 2:42 PM Siemens: Contract 030421-SIE | Sourcewell https://www.sourcewell-mn.gov/cooperative-purchasing/030421-sie 1/4 Siemens Facility Security, Fire, & Building Automation Systems #030421-SIE Maturity Date: 04/22/2025 Products & Services Sourcewell contract 030421-SIE gives access to the following types of goods and ser vices: IP CCTV surveillance systems Access control systems Intrusion detection Fire protection systems Advanced video analytics Security command & control Physical security information Building automation systems Mass notification          Buy SourcewellDocumentsContact InformationProducts & Services   DocuSign Envelope ID: DB053680-38C3-450E-AF31-FC6CE9F0C665 3/29/23, 2:42 PM Siemens: Contract 030421-SIE | Sourcewell https://www.sourcewell-mn.gov/cooperative-purchasing/030421-sie 2/4 Mass notification Installation Locate your local dealer or representative (nongovernment site) Additional information can be found on the vendor-provided, nongovernment website at: siemens.com/sourcewell   Buy Sourcewell Login to unlock more contract features. 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All questions related to content on external sites should be addressed directly to the host of that particular website. DocuSign Envelope ID: DB053680-38C3-450E-AF31-FC6CE9F0C665 3/29/23, 2:42 PM Siemens: Contract 030421-SIE | Sourcewell https://www.sourcewell-mn.gov/cooperative-purchasing/030421-sie 4/4 Terms & Conditions Privacy Policy Accessibility All Solutions  Minnesota-Only Solutions  Supplier Resources   © 2023 Sourcewell. All rights reserved. DocuSign Envelope ID: DB053680-38C3-450E-AF31-FC6CE9F0C665