CN-370000-CN210-T23CO2.pdf
PDF 6 MB Posted
- Contract number
- CN210
- 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 No. CN210 involving CPH, Inc. as the consultant. The change order pertains to Task Assignment No. 23 at Wekiwa Springs State Park in Florida, with Project No. 61188C focused on the Park Entrance improvements. Key personnel include Jason Toole, P.E. (Consultant Representative) and Philip Stone (FDEP Contract Manager). The document was executed in September 2020 with digital signatures from all required FDEP representatives and the consultant.
This change order is a time-only modification with no adjustment to the contract amount, extending the task completion deadline by 244 days from December 1, 2020 to August 2, 2021. The modification authorizes the consultant to complete design and permitting for a right-turn lane and multi-use path, provide Gopher Tortoise services, and perform construction administration services. The total task amount remains unchanged at $136,167.57, comprising $1,946.25 in reimbursable expenses and $134,221.32 in fixed fees. The original task execution date was August 28, 2019, and the change order was approved by FDEP's Budget Representative, Project Manager, Contract Manager, and Contract Authority, along with the consultant's authorization.
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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:
CN210 23 02 61188C
Wekiwa Springs State Park Park Entrance
CPH, Inc.
Jason Toole, P.E. 850-563-1490x4801jtoole@cphcorp.com
Philip Stone 850-245-2570 Philip.stone@FloridaDEP.gov
Time only change order to complete design and permitting for a right-turn lane and multi-use path, Gopher Tortoise services, and construction administration services per the attached email dated 9/24/2020.
$ 883.25 $ 55,270.35 $ 56,153.60 $ 1,946.25 $ 134,221.32 $ 136,167.57
$ 0.00 $ 0.00 $ 0.00 $ 1,946.25 $ 134,221.32 $ 136,167.57
8/28/19
12/1/20
12/1/20
8/2/21
Greg Turral Gregory Turral Digitally signed by Gregory Turral Date: 2020.09.24 14:23:54 -04'00'
Theresa Carron Theresa Carron Digitally signed by Theresa Carron Date: 2020.09.24 10:04:51 -04'00'
Philip Stone P.T. Stone Digitally signed by P.T. Stone Date: 2020.09.25 15:14:43 -04'00'
Jason Toole, P.E.
Digitally signed by Jason L Toole DN: C=US, O=Unaffiliated, OU=A01427D00000166A6FDA0460000440C, CN=Jason L Toole Reason: I am the author of this document Location:
Date: 2020-09-28 14:43:48 Foxit PhantomPDF Version: 9.2.0
Jason L Toole
Bryan Bradner Bryan Bradner Digitally signed by Bryan Bradner Date: 2020.11.12 13:54:11 -05'00'
$ 0.00
File details come from the government source that posted it. Updated .