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Home My WebLink About2025-514-E-AMS-Siemens Industry-Hillsborough Commons - Add Devices per Fire MarshaRevised 04/23 ORANGE COUNTY CHANGE ORDER REQUEST NORTH CAROLINA ______________________________________________________________________________________________________________ Date: 08/15/2025 Project: Hilllsborough Commons Fire Alarm Replacement Change Order No. 02 Department: AMS Department Address: 306 Revere Road, Hillsborough NC 27278 Project: Hillsborough Commons Fire Alarm Replacement Contractor: Siemens Industry, Inc. Contractor Address: 215 Southport Drive, Ste 900, Morrisville, NC 27560 Effective date of original contract: 08/05/2024 This change order increases decreases the contract time by 92 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: 09/30/2025 _______________________________________________________________________________________________________________ Full Description of Change: This change order is to install (5) additional smoke detectors and bases, (3) wall strobes, (3) three horn strobes, (3) door relays, and (1) tamper switch per the fire marshal. Reason for Change: The additional changes are for adding additional devices per the fire marshal. _______________________________________________________________________________________________________________ Original contract sum: $ 249,987.00 Contract sum prior to this change order: $ 254,867.78 Amount of this change order: $ 15, 580.55 Total sum of the contract including this change order: $ 270,448.33 _______________________________________________________________________________________________________________ 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 15th day of August, 2025. _______________________________ _____________________________ _____________________________ Contractor Owner Architect (when retained) By:____________________________ By:___________________________ By:___________________________ Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Area Geneeral Manager 8/12/2025 8/20/2025 County Manager Revised 04/23 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Siemens Industry, Inc Vendor Contact Person: Sepesi, Ella (ella.sepesi@siemens.com) Phone: 919.389.4449 Address: 215 Southport Drive, Ste 900 City Morrisville State: NC Zip: 27560 Department: AMS Amount: $15,580.55 Purpose: Hillsborough Commons - Add Devices per Fire Marshal Budget Code(s): 61370035-800000-11006 Vendor # 53325 Vendor Status with NCSOS: Active Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: 8/5/2024) (Most Recent Amendment 10/16/2024) Effective Date 8/5/2024 End Date 6/30/2025 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: 17000) 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 project 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: 015115AB-A8FE-4204-85BF-10FBDEC70CDA 8/12/2025 8/18/2025 8/19/2025 8/19/2025 PROPOSAL PCO Hillsboro SVC 44OP-384065 PREPARED BY Siemens Industry, Inc. ("Siemens") PREPARED FOR ORANGE COUNTY ASSET MANAGEMENT SERVICES DELIVERED ON June 30, 2025 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Table of Contents SIEMENS PROPOSAL .......................................................................................................3 Contact Information ..............................................................................................3 Conditions of Request ............................................................................................4 Scope of Work Change order ..................................................................................5 Inclusions ..............................................................................................................5 Exclusions .............................................................................................................6 Clarifications .........................................................................................................7 Sell Price ................................................................................................................8 Payment Terms ......................................................................................................9 TERMS OF SALE ............................................................................................................10 Siemens Terms of Sale (STS)................................................................................10 Signature Page .............................................................................................................11 Signature Page ....................................................................................................11 Page 2 of 11 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Proposal #:9872532 Date:June 30, 2025 Contact Information Sales Executive:Nelson Ciuffardi Branch Address:215 Southport Dr. Suite 900 Morrisville, NC,27560 Telephone:984.389.5833 Email Address:nelson.ciuffardi@siemens.com Customer Contact:Angel Barnes Customer:ORANGE COUNTY ASSET MANAGEMENT SERVICES Address:600 NC HIGHWAY 86 N HILLSBOROUGH NC 27278-8225 Services shall be provided at:Hillsborough Commons Social Services 113 Mayo St, Hillsborough, NC 27278 Page 3 of 11 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Conditions of Request We transmit herewith the above referenced price request for Change Order 1 to the contract between Siemens Industry, Inc. ("Siemens") and ORANGE COUNTY ASSET MANAGEMENT SERVICES dated AUG52024for the Base Contract Name HCOB Fire Alarm Replacement.This price request is based on information received from your company and is subject to the following conditions: 1.No change in contract price. 2.X Change of $$15,580.55 in contract price. 3.days of extension of contract. Retention shall be extended only on value of price request. 4.We are not proceeding until we received a change order. 5.Work is proceeding as authorized. 6.Please forward a cost event & change order to this office since the work has been completed. This proposal covers the present ascertainable direct costs at this time.It does not include any extra costs associated with the impact of this Change Order on the project schedule, labor productivity or their factors affecting the cost of performance.Siemens reserves the right to amend this proposal if and when such impact costs become reasonably determinable.The Description of Changes is attached hereto and made apart hereof.The Agreement is incorporated by reference, modified only to the extent modified herein. Page 4 of 11 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Scope of Work Change order 1.Five (5) Siemens Smoke Detector and base. 2.Three (3)Siemens Wall Strobe 3.Three (3)Siemens Horn Strobe 4.Three (3) Door Relays 5.One (1) Siemens Tamper Switch Exclusions and Clarifications Work to be performed on regular time Inclusions 1.Freight 2.Engineering 3.Project Management for Siemens Scope of work 4.Electrician 5.Supply or installation of any electrical conduits, cables, wiring or back boxes, and equipment 6.As interpreted in the specifications, as shown on drawings, and as defined in this proposal 7.One (1) year warranty 8.Final wiring terminations to the control panel 9.Programming 10.Testing Page 5 of 11 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Exclusions 1.Cost associated with multiple trips to the job site due to incompletion by others 2.Working in areas containing hazardous materials or confined space 3.Cost associated with schedule acceleration or multiple unplanned phases 4.Costs associated with bypassing the system during construction 5.Building and construction permit fees 6.Ceiling and/or wall removal, replacement, patching, and painting 7.Per project aggregate general liability insurance 8.Overtime 9.After hours work 10.DOL and additional testing due to others 11.120 VAC power 12.Conduit raceway, Electrical boxes and supports 13.Performance or payment bonds 14.Bonding or special insurance 15.Fire caulking 16.Scaffolding and lifs 17.Security system interface or door lock release 18.Fire Watch or other costs associated with temporary measures while the system is down or impaired 19.The proposal excludes all applicable taxes. Sales tax will not be included on the invoice unless Siemens receives a completed NCDOR E589CI (North Carolina Affidavit of Capital Expenditures). We have included an NCDOR E589CI form with this proposal for your convenienc Page 6 of 11 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Clarifications 1. Siemens will provide the fire alarm permit, review and inspection fees. 2. Owner will need to allow Siemens full and complete access to the property for the duration of the project. 3. All scheduling and phasing will need to have the Owner's input and will require the Owner's cooperation to complete during the allotted time. 4. All work to be performed during normal working hours of Monday thru Friday, 6:00am to 4:00pm Page 7 of 11 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Sell Price Total Quote Price $15,580.55* This price is firm for 30 days from the date of this proposal. *Siemens reserves the right to adjust prices to reflect the impact of any new or modified taxes, duties, tariffs, or equivalent measures, whether direct or indirect, imposed by any U.S. or foreign governmental authority that are applicable to our offering, including any hardware, software, or service components contained therein. Page 8 of 11 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Payment Terms Payment Terms Acceptance Agreement The total price of:$15,580.55 and the estimated return on investment are based on the items outlined in this proposal.ANY STATEMENTS MADE HEREIN REGARDING SAVINGS THAT MAY BE ACHIEVED BY IMPLEMENTING THE SERVICES OFFERED IN THIS PROPOSAL ARE ESTIMATES ONLY. NO WARRANTY, EITHER EXPRESSED OR IMPLIED, SHALL BE CONSTRUED TO ARISE FROM SUCH STATEMENTS, NOR SHALL SUCH STATEMENTS BE CONSTRUED AS CONSTITUTING A GUARANTEE BY SIEMENS THAT SUCH SAVINGS WILL OCCUR IF THE SERVICES ARE IMPLEMENTED. The Buyer acknowledges that when accepted by the Buyer as proposed by Siemens Industry, Inc., this Proposal and the Siemens Buildings Projects Business Standard Terms and Conditions, (together with any other documents incorporated into the forgoing) shall constitute the entire agreement of the parties with respect to its subject matter.BY EXECUTION HEREOF, THE SIGNER CERTIFIES THAT (S)HE HAS READ ALL OF THE TERMS AND CONDITIONS AND DOCUMENTS, THAT SIEMENS OR ITS REPRESENTATIVES HAVE MADE NO AGREEMENTS OR REPRESENTATIONS EXCEPT AS SET FORTH THEREIN, AND THAT (S)HE IS DULY AUTHORIZED TO EXECUTE THE SIGNATURE PAGE ON BEHALF OF THE BUYER. Proposal is valid for thirty (30) days from the delivery date of June 30, 2025. Payment is due within 30 days of invoice date. Payment Terms: 25% mobilization in advance, progress payments Total:$15,580.55 Siemens Industry, Inc. invoices paid by credit card may be subject to a surcharge of up to 2%. Page 9 of 11 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Siemens Terms of Sale (STS) Terms of Sale (Click to download) Base Terms (www.siemens.com/base-terms) Buyer agrees that Siemens shall be authorized, at its discretion and without consent, to utilize any of its world-wide affiliates to perform (subcontract) work under this Agreement. (Buyer agrees that) Buyer's data may be viewed or accessed from outside the United States by Siemens world-wide affiliates.Buyer data may be stored and/or accessed in the United States or other countries in which Siemens or our (subcontract) affiliates operate. Price Escalation.If, during the term of this Contract, the price of various materials or labor or logistics are increased as reflected by CRU/IHS Markit/CMAI/COMEX market index, then Siemens may increase the Contract Sum or apply a surcharge to Customer accordingly. To the extent applicable, the following Supplements are incorporated and made part of the Siemens Terms of Sale: Click on supplement(s) below to read/download Solutions Supplemental Terms (www.siemens.com/project-supplemental-terms) Hardware Supplemental Terms (www.siemens.com/product-supplemental-terms) Page 10 of 11 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA Signature Page Proposed by:Accepted by: Siemens Industry, Inc. ______________________________________ Company ORANGE COUNTY ASSET MANAGEMENT SERVICES _____________________________________ Company Nelson Ciuffardi ______________________________________ Name _____________________________________ Name (Printed) 9872532 ______________________________________ Proposal # _____________________________________ Signature $15,580.55 ______________________________________ Proposal Amount _____________________________________ Title June 30, 2025 ______________________________________ Date _____________________________________ Date _____________________________________ Purchase Order #⬜PO for billing/pmnt only ⬜PO not required Page 11 of 11 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA 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 10/01/2024 N/A 4433 of Marsh USA LLC X RENTA C N/A 10,000,000 UB-8P79233A-24-51-R (AZ,MA,WI) 41343 A 10/01/2025 X Travelers Casualty & Surety Company CN102147003-RAM--24/25 1,000,000 25674 ... NYC-009196547-33 10/01/2024 X INCL 10/16/2024 10/01/2025 '''''''''''$500K LIMIT / $500K SIR''''''''''' 10 N/A 10/01/2025 NOC60 1,000,000 X 1,000,000 1,000,000 B 10/01/2025 10/01/2024 19038 TC2J-CAP-7440L34A-TIL-24 100,000 10/01/2024 UB-8P83929A-24-51-K (AOS) TWXJUB-7440L338-TIL-24 (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 GLD1110116 Travelers Property Casualty Co. of America N PO BOX 8181 HILLSBOROUGH, NC 27278 ORANGE COUNTY ATTN: RISK MANAGEMENT 10/01/2024 B 2,000,000 X X 10/01/2025 Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA 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. �� EXTENT THAT A CLAIM ARISES FROM THE NEGLIGENCE OF SIEMENS INDUSTRY, INC. OR ITS SUBCONTRACTORS WITH RESPECT TO ALL OPERATIONS OF THE CONTRIBUTORY INSURANCE TO THE�� ORANGE COUNTY, ITS OFFICERS, OFFICIAL AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED UNDER THE ABOVE REFERENCED GENERAL �� LIABILITY INSURANCE POLICIES AND THE COVERAGE AFFORDED THE ADDITIONAL INSURED UNDER THESE POLICIES SHALL BE PRIMARY AND NON- LIABILITY AND AUTOMOBILE�� WAIVER OF SUBROGATION IS EFFECTUAL WHERE REQUIRED BY WRITTEN CONTRACT. �� INSURED BUT ONLY WITH�� 2 Morristown Certificate of Liability Insurance �� IF THESE POLICIES ARE CANCELLED FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE INSURER WILL DELIVER NOTICE OF CANCELLATION TO �� RESPECT TO ALL WORK PERFORMED BY AND ON BEHALF OF THE NAMED INSURED, SIEMENS INDUSTRY, INC. FOR CERTIFICATE HOLDER UNDER CONTRACT. �� THE CERTIFICATE HOLDER UP�� 25 �� RE: JOB NO. N/A�� UMBRELLA IS FOLLOW FORM OF PRIMARY SUBJECT TO POLICY TERMS, CONDITIONS AND EXCLUSIONS. �� 1000 DEERFIELD PARKWAY��SIEMENS INDUSTRY, INC.�� BUFFALO GROVE,IL 60089-4513�� TO 60 DAYS PRIOR TO THE CANCELLATION OR AS REQUIRED BY WRITTEN CONTRACT, WHICHEVER IS LESS. �� 2 CN102147003 �� Docusign Envelope ID: 015115AB-A8FE-4204-85BF-10FBDEC70CDA