Florida Department of Environmental Protection

TASK ASSIGNMENT NOTIFICATION FORM

Required Signatures: Adobe Signature

FDEP Contract No.: Task Assignment No.: Owner’s Name: Project No.:

Project Location: Project Name:

Consultant Name:

Consultant Representative: Phone: Email:

FDEP Contract Manager: Phone: Email:

Project Manager:

Schedule Start Date: Fixed Price Cost:

Completion Date: Cost Reimbursement not to exceed:

Total Task Amount:

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:

CN 210 39 FDEP-DRP 61499C

Fort Clinch - SP Road Repair and Waterline Replacements.

CPH

Kayla Sheffield 904-332-0999 ksheffield@cphcorp.com

Ralph Perkins 850-245-2640 Ralph.Perkins@FloridaDEP.gov Description of Task:

Professional services for Road Repair and Waterline Replacement

Del Cobb

Upon Execution $ 01/10/2025

Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2023.01.11 16:20:28 -05'00'

Del Cobb Del Cobb Digitally signed by Del Cobb Date: 2023.01.12 09:03:16 -05'00'

Ralph Perkins

Kayla Sheffield

Michael Foster Jr. P.E.

61499C 37502000027 080039/23 423001 U3200 131500 QK $

Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2023.01.12 10:25:47 -05'00'

Digitally signed by Kayla Sheffield DN: C=US, O=Florida, dnQualifier=A01410D0000017E44A031F90000010E, CN=Kayla Sheffield Date: 2023.01.13 10:45:55-05'00' Foxit PhantomPDF Version: 10.1.4

1/13/23

Michael W. Foster Jr., P.E. Michael W. Foster Jr., P.E.

Digitally signed by Michael W. Foster Jr., P.E.

Date: 2023.01.23 13:10:08 -05'00'