CN-370000-CN202-T43CO2.pdf
PDF 290 KB Posted
- Contract number
- CN202
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) for Contract CN202, Task Assignment 43, Change Order 02. The contracting parties are the State of Florida through FDEP and Michael Baker International, a consulting firm. The project involves repaving work on the Withlacoochee Trail, with FDEP Contract Manager Ralph Perkins overseeing the assignment and Michael Baker International's representative Jeff Roberts, PE, serving as the consultant lead.
The change order addresses a time extension only, with no modification to the financial terms of the task assignment. The original task execution date was December 21, 2022, with an original end date of June 15, 2024. This change order extends the task completion deadline by 255 days to February 25, 2025, to accommodate construction phase services and project closeout activities. The total task amount remains at $97,459.88, comprising $100.00 in reimbursement and $97,359.88 in fixed fees. The time extension was requested by the consultant via email dated May 1, 2024, and was approved by all required FDEP representatives and the consultant between May 1 and May 6, 2024.
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Text version
Florida Department of Environmental Protection
TASK ASSIGNMENT CHANGE ORDER FORM
( ) 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:
CN202 43 02 61480C
Withlacoochee Trail Repave Trail
Michael Baker International
Jeff Roberts, PE 850-701-2303 jeff.roberts@mbakerintl.com
Ralph Perkins 850-245-2460 Ralph.Perkins@FloridaDEP.gov
Addition of time only to allow for completion of tasks during construction phase per the attached email request dated 5/1/2024.
$ 100.00 $ 76,447.04 $ 76,547.04 $ 100.00 $ 97,359.88 $ 97,459.88 $ 0.00 $ 0.00 $ 0.00
$ 100.00 $ 97,359.88 $ 97,459.88
12/21/2022
6/15/2024
6/15/2024
2/25/2025
Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2024.05.01 16:07:39 -04'00'
Theresa Carron T.Carron Digitally signed by T.Carron Date: 2024.05.01 16:09:24 -04'00'
Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2024.05.02 08:54:16 -04'00'
Jeff Roberts, PE Jeff Roberts Digitally signed by Jeff Roberts Date: 2024.05.02 09:19:13 -04'00'
Michael W. Foster Jr., P.E. Michael W. Foster Jr., P.E.
Digitally signed by Michael W.
Foster Jr., P.E.
Date: 2024.05.06 15:00:04 -04'00'
$ 0.00
Carron, Theresa
From: Roberts, Jeff <Jeff.Roberts@mbakerintl.com> Sent: Wednesday, May 1, 2024 2:07 PM To: Carron, Theresa Cc: Buschow, Travis; Gable, Jay Subject: Time extension request - TA43, CN202: Withlacoochee Trail Repaving Attachments: CN202 TA43 CO1 Withlacoochee-Repave Trail-signed-.pdf
EXTERNAL MESSAGE
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File details come from the government source that posted it. Updated .