CN-370000-CN210-T49CO2.pdf

Florida Department of Environmental Protection

TASK ASSIGNMENT CHANGE ORDER FORM

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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 49 02 61518C

Big Shoals State Park Underground Septic System

CPH, Inc.

Kayla Sheffield P.E. (904) 332-0999 ksheffield@cphcorp.com

Ralph Perkins, or successor 850-245-2460 Ralph.Perkins@FloridaDEP.gov

Deductive Time to have project revert back to the contract's end date which is 03/03/2025 per the attached letter dated 08/06/2024.

$ 2,139.00 $ 39,691.76 $ 41,830.76 $ 47,099.75 $ 47,099.75

$ 0.00 $ 0.00 $ 0.00 $ 47,099.75 $ 47,099.75

06/22/2023

06/13/2026

06/13/2026

03/03/2025

Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2024.09.16 14:45:35 -04'00'

Joel Pollock Joel Pollock Digitally signed by Joel Pollock Date: 2024.09.16 15:07:36 -04'00'

Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2024.09.17 11:24:23 -04'00'

Kayla Sheffield, P.E. Kayla Sheffield

2024.09.20 11:00:05-04'00'

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

Digitally signed by Michael W.

Foster Jr., P.E.

Date: 2024.10.01 09:48:21 -04'00'

$ 0.00

Pollock, Joel

From: Kayla Sheffield <ksheffield@cphcorp.com> Sent: Tuesday, August 6, 2024 4:36 PM To: Pollock, Joel Subject: Re: Big Shoals Underground Septic System deductive time CO

EXTERNAL MESSAGE

This email originated outside of DEP. Please use caution when opening attachments, clicking links, or responding to this email.

Joel, CPH is ok with the TA reverting to 3/3/25. Confirming this is a difference of 1 year, 3 months, 1 week, and 3 days.

Thank you, Kayla Sheffield, P.E.

Branch Manager - Jacksonville ksheffield@cphcorp.com o 904.332.0999x4401 c 904.705.3125

BUILDING STRONGER COMMUNITIES TOGETHER

Hi Kayla, As discussed, We need a confirmation email saying that you/CPH are ok with the TA reverting to the date of 03/03/2025 which is a difference of 1 year, 3 months, 1week, and 3 days.

We will eventually add the deductive time change email to the same change order that will accompany the CRAS study proposal.

Please respond with confirmation of the new date including the difference in time as soon as you are able.

Thank you ma’am, Joel

Joel Pollock, FCCM Design Project Manager Bureau of Design and Construction Department of Environmental Protection Joel.Pollock@FloridaDEP.gov Office: (850) 245-2062 Cell: (850) 408-1262

This communication does not constitute an authorization for any increase in the scope of work, cost, or time for the project being discussed. All changes to services, cost, or time must be accomplished in accordance with the formal process outlined in the contract. The DEP objects to, and shall not be responsible for, any changes to services, costs, or additional time not authorized by an executed Contract Amendment, Task Assignment Change Order, Construction Change Order, or Construction Change Directive, as appropriate for this contract.

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