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HomeMy WebLinkAbout2023-629-E-AMS-Siemens Industry-Passmore Center - Additional NAC devices, Overtime for Adult Day and Point ID programmingRevised 04/23 ORANGE COUNTY CHANGE ORDER REQUEST NORTH CAROLINA ______________________________________________________________________________________________________________ Date: 10/23/2023 Project: Passmore Center Fire Alarm Replacement Change Order No. 02 Department: AMS Department Address: 306 Revere Road, Hillsborough NC 27278 Project: Passmore Center Fire Alarm Replacement Contractor: Siemens Industry, Inc. Contractor Address: 215 Southport Drive, Morrisville, NC 27560 Effective date of original contract: 4/7/2023 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: Provide (12) additional NAC devices to cover the current system and substitute all devices one for one. Provide work on overtime for the Adult day center as to avoid disruptions to the adults in the daycare center. Provide additional programming for Point ID Description per FM request. Reason for Change: Additional devices were found while performing investigations, as this work progresses and meeting with staff it is best not to disrupt the operations of the adult day center and for this work to be performed after hours. During discussions with the fire marshal she is asking that this system be set up with point identification for each device which requires additional programming. _______________________________________________________________________________________________________________ Original contract sum: $ 121,514.00 Contract sum prior to this change order: $ 126,914.00 Amount of this change order: $ 31,269.88 Total sum of the contract including this change order: $ 158,183.88 _______________________________________________________________________________________________________________ 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 26th day of October, 2023. _______________________________ _____________________________ _____________________________ Contractor Owner Architect (when retained) By:____________________________ By:___________________________ By:___________________________ DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB Branch General Manager 10/26/2023 10/31/2023 County Manager Revised 04/23 DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB Revised 04/23 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Siemens Industry, Inc Vendor Contact Person: Antony Puello (antony.tejada-puello@siemens.com) Phone: 919.389-4449 Address: 215 Southport Drive, Suite 900 City Morrisville State: NC Zip: 27560 Department: AMS Amount: $5400.00 Purpose: Passmore Center - Additional NAC devices, Overtime for Adult Day and Point ID programming Budget Code(s): 61370035-880000-30001 Vendor # 53325 Vendor Status with NCSOS: Active Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: 4/7/2023) (Most Recent Amendment 9/20/2023) Effective Date 10/26/2023 End Date 6/30/2024 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: Facility Accessibility, Safety & Security) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(#Proprietary) 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 related 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: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB 10/26/2023 10/30/2023 10/31/2023 10/31/2023 DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB 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-MAILADDRESS: 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 EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR 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 B 10/01/2023 N/A 4433 of Marsh USA LLC X RENTA C N/A 10,000,000 UB-8P79233A-23-51-R (AZ,MA,WI) 41343 A 10/01/2024 X Travelers Casualty & Surety Company CN102147003-RAM--23/24 1,000,000 25674 ... NYC-009196547-32 10/01/2023 X INCL 09/26/2023 10/01/2024 '''''''''''$500K LIMIT / $500K SIR''''''''''' N/A 10/01/2024 NOC60 1,000,000 X 1,000,000 1,000,000 B 10/01/2024 10/01/2023 19038 TC2J-CAP-7440L34A-TIL-23 100,000 10/01/2023 UB-8P83929A-23-51-K (AOS) TWXJ-UB-7440L338-23 (OH) X 1,000,000 SEE ATTACHED RE: JOB NO. N/A 1000 DEERFIELD PARKWAY SIEMENS INDUSTRY, INC. BUFFALO GROVE, IL 60089-4513 1,000,000 HDI Global Insurance Company X 445 SOUTH STREET MARSH USA, LLC. MORRISTOWN, NJ 07960-6454 GLD1110115 Travelers Property Casualty Co. of America N PO BOX 8181 HILLSBOROUGH, NC 27278 ORANGE COUNTY ATTN: RISK MANAGEMENT 10/01/2023 B 2,000,000 X X 10/01/2024 DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB 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: MARSH USA, LLC.� � WAIVER OF SUBROGATION IS EFFECTUAL WHERE REQUIRED BY WRITTEN CONTRACT. � SUBCONTRACTORS WITH RESPECT TO ALL OPERATIONS OF THE INSURED BUT ONLY WITH RESPECT TO ALL WORK PERFORMED BY AND ON BEHALF OF THE PRIMARY AND NON-CONTRIBUTORY INSURANCE TO THE EXTENT THAT A CLAIM ARISES FROM THE NEGLIGENCE OF SIEMENS INDUSTRY, INC. OR ITS � NAMED INSURED, SIEMENS INDUSTRY, INC. FOR CERTIFICATE HOLDER UNDER CONTRACT. � � RE: JOB NO. N/A� ORANGE COUNTY, ITS OFFICERS, OFFICIAL AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED UNDER THE ABOVE REFERENCED GENERAL THE CERTIFICATE HOLDER UP TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. � UMBRELLA IS FOLLOW FORM OF PRIMARY SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS. � 2 Morristown Certificate of Liability Insurance � � 25 LIABILITY AND AUTOMOBILE LIABILITY INSURANCE POLICIES AND THE COVERAGE AFFORDED THE ADDITIONAL INSURED UNDER THESE POLICIES SHALL BE IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO 1000 DEERFIELD PARKWAY� SIEMENS INDUSTRY, INC.� BUFFALO GROVE, IL 60089-4513 2 CN102147003 DocuSign Envelope ID: 43C53CD1-A22E-493F-97E4-F749FEF5D6CB