CN-370000-CN212-T8CO3.pdf
PDF 2 MB Posted
- Contract number
- CN212
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 03) issued by the Florida Department of Environmental Protection (FDEP) for contract CN212, Task Assignment 8. The consultant is Dodstone Architects, represented by Karin Zawrotny, AIA, with FDEP's Don Page serving as the contract manager. The project involves the Florida Geological Survey Phase III Renovations located in Florida, with project numbers 61211C and 61210C.
The change order authorizes Dodstone Architects to submit an initial permit application for the Florida Geological Survey Phase III Renovations project to the City of Tallahassee. The scope of work (Task 5d) includes assisting FDEP in completing the permit application, uploading signed and sealed drawings to the permitting office, and paying the initial permit application fee. The net increase for this change order is $4,616.00, bringing the total task amount with all change orders to $54,389.49. This comprises $4,700.00 in reimbursable expenses (with a permitted permit fee not to exceed $4,000.00) and $49,689.49 in fixed fees. The work must be completed by December 31, 2021. Deliverables include electronic copies of application forms and documentation of receipt and permit fees, with performance measures requiring FDEP review to confirm completeness, accuracy, and timeliness.
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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:
CN212 TA8 03 61211C & 61210C
Florida Geological Survey Florida Geological Survey Phase III Renovations
Dodstone Architects
Karin Zawrotny, AIA 850-656-7326 kzawrotny@dodstone.com
Don Page 850-245-2671 don.page@dep.state.fl.us
Submit initial permit application for Florida Geological Survey Phase III Renovations project to the City of Tallahassee. See attached proposal dated December 10, 2020.
$ 700.00 $ 44,402.63 $ 45,102.63 $ 700.00 $ 49,073.49 $ 49,773.49
$ 4,000.00 $ 616.00 $ 4,616.00 $ 4,700.00 $ 49,689.49 $ 54,389.49
11/12/2019
12/31/2020
12/31/2021
12/31/2021
Greg Turral Gregory Turral Digitally signed by Gregory Turral Date: 2020.12.11 14:03:11 -05'00'
Don Page Don Page Digitally signed by Don Page Date: 2020.12.11 14:12:55 -05'00'
Alyssa Skehan Alyssa Skehan Digitally signed by Alyssa Skehan Date: 2020.12.17 11:09:56 -05'00'
Joel Dodson Joel L Dodson Digitally signed by Joel L Dodson Date: 2020.12.17 11:42:18 -05'00'
Michael Foster Michael W. Foster Jr.
Digitally signed by Michael W.
Foster Jr.
Date: 2020.12.17 13:47:06 -05'00'
61210C 37050101002 083643/20 408001 U3200 134000 PF $ 2,308.00
61211C 37050101002 083643/20 408001 U3200 131500 PF $ 2,308.00
$ 4,616.00
File details come from the government source that posted it. Updated .