CN-370000-CN200-T12CO3.pdf
PDF 828 KB Posted
- Contract number
- CN200
- Issued by
- Florida
About this file
This document is a Task Assignment Change Order Form from the Florida Department of Environmental Protection (FDEP) for a project involving George F. Young, Inc., a civil and transportation engineering consulting firm based in Lakewood Ranch, Florida. The change order pertains to Contract CN200, Task Assignment TA12, for the Topsail Hill Preserve State Park Bathhouse Replacement project located in Topsail Hill Preserve State Park. The FDEP Contract Manager is Don Page, and the consultant representative is Mark A. Adler, PE.
The change order extends the task assignment completion date from December 1, 2022 to December 31, 2023, representing a net increase of 395 days. This is designated as a no-cost extension with zero net increase to the task amount. The total task amount with all change orders remains $39,109.59, comprising $1,529.02 in reimbursement and $37,580.57 in fixed fees. The original task amount was $26,823.88. The change order was executed on September 26, 2022, with signatures from the FDEP Budget Representative, Project Manager, Contract Manager, and Contract Authority, as well as the consultant representative from George F. Young, Inc.
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Text version
Florida Department of Environmental Protection
TASK ASSIGNMENT CHANGE ORDER FORM
(Revised 9-26-2018) Page 1 of 1
Required Signatures: Adobe Signature
FDEP Contract No.: Task Assignment No.: Change Order No.: Project No.:
Project Location: Project Name:
Consultant Name:
Consultant Representative: Phone: Email:
FDEP Contract Manager: Phone: Email:
Description and Justification of Change:
Change in Task Amount:
Item Reimbursement Fixed Fee Total
Original Task Amount:
Task amount including all previous Change Orders:
Net increase/decrease in task amount for this Change Order:
Total Amounts with all Change Orders:
Change in Task Time:
Original Task Execution Date:
Original Task End Date:
Present Task End Date:
Net Change in Days:
New Task End Date:
Approval Signatures:
Budget Representative, FDEP Signature Date
Project Manager, FDEP Signature Date
Contract Manager, FDEP Signature Date
Consultant Signature Date
Contract Authority, FDEP Signature Date
Project # Grant # Org Code Cat/Year Fund Module Object Code EO Amount
29 Digit FLAIR Code: Total:
CN200 TA12 3 61154C
Topsail Hill Preserve State Park Bathhouse Replacement
George F. Young, Inc.
Mark A. Adler, PE 904-747-2981 madler@georgefyoung.com
Don Page 850-245-2671 don.page@FloridaDEP.gov
Extend the Task Assignment for this project to 12/31/2023. This is a no cost extension. See attached document dated 9/9/2022.
$ 26,823.88 $ 26,823.88 $ 1,529.02 $ 10,756.69 $ 12,285.71
$ 0.00 $ 0.00 $ 0.00 $ 1,529.02 $ 37,580.57 $ 39,109.59
1/23/2020
7/1/2022
12/1/2022
12/31/2023
Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2022.09.20 09:43:12 -04'00'
Don Page Don Page Digitally signed by Don Page Date: 2022.09.20 13:04:08 -04'00'
Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2022.09.22 10:25:24 -04'00'
Mark A. Adler, PE
Michael W. Foster Jr., P.E. Michael W. Foster Jr., P.E.
Digitally signed by Michael W.
Foster Jr., P.E.
Date: 2022.09.26 11:16:52 -04'00'
$ 0.00
Digitally signed by Mark Alan Adler Date: 2022.09.22 16:27:16 -04'00'
GAINESVILLE | LAKEWOOD RANCH | ORLANDO | PALM BEACH | ST. PETERSBURG | TAMPA
Passionately committed to
Integrity | Quality | Service
George F. Young, Inc.
Turning Vision into Reality Since 1919
CIVIL & TRANSPORTATION ENGINEERING | ECOLOGY | GIS | LANDSCAPE ARCHITECTURE | PLANNING | SURVEYING | SUBSURFACE UTILITY ENGINEERING
10540 Portal Crossing, Suite 105 Lakewood Ranch, FL 34211-4913
(941) 747-2981 Phone | (941) 747-7234 Fax www.georgefyoung.com
September 9, 2022
Mr. Don Page Florida Department of Environmental Protection Bureau of Design and Construction 3800 Commonwealth Boulevard 260B, MS 520 Tallahassee, FL 32399
RE: DEP Agreement CN200 TA12 CO2 (Task Assignment 12 Change Order #3)
Topsail Hill Preserve State Park – Bathhouse Replacement Agreement Time Extension Request
Dear Mr Page, By way of this letter, as a result of the FDEP’s intention to extend the referenced project duration from December 1, 2022 to December 31, 2023, we correspondingly request an extension of our firm’s Agreement for this project until December 31, 2023.
If you have any questions or need additional information, please contact me at (941)747-2981
Ext. 8210.
Sincerely, GEORGE F. YOUNG, INC.
Mark A. Adler, PE Sr. Vice President – Lakewood Ranch Engineering
I:\PROJECT\ENG\2015\15Y00108GC\Docs\Contract\2022-09-09 Letter for Topsail Hill SP - Agreement Extension.docx
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| Task Assignment Change Order Form.pdf |
| 2022-09-09 Letter for Topsail Hill SP - Agreement Extension.pdf |
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