Florida Department of Environmental Protection

TASK ASSIGNMENT CHANGE ORDER FORM

Required Signatures: Adobe Signature

FDEP Contract No.: I Task Assignment No.: Change Order No.: I Project No.:

CN214 15 03 61124C

Project Location: Project Name:

Paynes Prairie Preserve State Park Upgrade Septic System Consultant Name:

George & Associates Consultant Representative: Phone: Email:

Robert George 850-521-0344 rgeorge@gaceng.net FDEP Contract Manager: Phone: Email:

Mae Roth 850-245-2781 Mae.Roth(a2dep.state.fl.us Description and Justification of Change:

Time extension only. Consultant's additional services are dependent upon start of construction and availability of funds for construction.

Ch angem as . Ti kA mount:

Item .,teffii'l~'J:1~~¢t11~ ·.· fit~Pi~ 'f<;jtaJ

Original Task Amount: $ 1.581.24 $ 43.458.10 $ 45.039.34 Task amount including all previous Change Orders: $ 2 878.86 $65,343.92 $68,222.78 Net increase/decrease in task amount for this Change Order: $ 0.00 $ 0.00 $ 0.00 Total Amounts with all Change Orders: $ 2 878.86 $ 65 343.92 $68,222.78

Ch angein as ime: • Ti k ri· Original Task Execution Date: 9/9/16

Original Task End Date: 12/31/17

Present Task End Date: 12/31/17

Net Change in Days: 365

New Task End Date: 12/31/18

Approval Signatures:

Greg Turral Greg Tu rra I Digitally signed by Greg Turral Date: 2017.12.1816:55:18-05'00' 12-18-2017

Budget Representative, FDEP

Brian Miller Project Manager, FDEP

Mae Roth Contract Manager, FDEP

Robert George, P.E.

Consultant

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

Contract Authority, FDEP

Proiect # Grant# Ore Code

29 Di1?it FLAIR Code:

000 - 012 (Effective 5-19-2016)

Signature

Brian Miller Signature

Mae Roth Signature

Digitally signed by Brian Miller Date: 2017.12.19 08:40:17-05'00'

Digitally signed by Mae Roth Date: 2017.12.19 08:42:47 -05'00'

Robert George Digitally signed by Robert George Date: 2017.12.19 09:35:47-05'00'

Signature

Date

12/19/2017 Date

12/19/2017 Date

12/19/2017

Datl

Cat/Year Fund Module Object Code EO Amount

Total: $ 0.00

Miller, Brian D.

From:

Sent:

To:

Cc:

Subject:

Robert George <rgeorge@gaceng.net> Friday, December 15, 2017 12:04 PM Miller, Brian D.

Michael Freidin Paynes Prairie Septic Tank Replacement

Brian, George & Associates is requesting a time extension for TAlS which is set to expire on 12/31/2017. I would recommend extending this current TA to 12/31/2018. The completion of our tasks is based on construction starting.

(:l) N ~u l. ·r IN (I 1'.:NCHNr. l~K~

Waiver of Liability Notice:

Robert George President George & Associates Consulting Engineers, Inc.

1967 Commonwealth Lane, Suite 200 Tallahassee, Florida 32303 P 850-521-0344 F 850-521-0345 M 850-510-5410 rgeorge@gaceng.net www.gaceng.net

This electronic format is provided for informational purposes only. It is intended exclusively for the individual or entity to which it is addressed. Users of this electronic format c current original signed ond sealed plans and specifications as prepared, issued, and held by George & Associates, Consulting Engineers, Inc. George & Associates, Consulting Er changes made electronically or otherwise. Information regarding any alleged conflicts, errors, or omissions should be submitted in writing to George & Associates, Consulting E party constitutes acceptance of this Waiver of Liability. If you have received this message In error, please notify the sender immediately by e-mail and delete all copies of the m