CN-370000-CN214-T19CO1.pdf

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Attached to
Master Agreement FL|CN214|9ee31443e44a9c909ef0ca196a4906cb
Contract number
CN214
Issued by
Florida

About this file

This document is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) for Contract No. CN214, Task Assignment No. TA19. The contracting parties include FDEP and George & Associates Consulting Engineers, Inc., represented by Robert George. The project is located at Dagny Johnson Key Largo Hammock Botanical State Park and concerns Port B Restoration efforts. The FDEP Contract Manager is Mae Roth, and the contract authority is Michael W. Foster Jr., P.E.

The change order authorizes a 92-day extension of the task assignment and funding for a pre-construction startup meeting required due to a new contractor assignment. The original task amount was $1,163.10 in reimbursement and $25,062.84 in fixed fees, totaling $26,225.94. This change order increases the task amount by $1,610.76, bringing the total with all change orders to $27,836.70. The original task execution period ran from February 14, 2017, to May 31, 2017. The change order extends the task end date by 92 days to August 31, 2017. The funding is allocated through Project No. 50423 with a grant code of 3750-5018-190 and object code 134000. All required FDEP approvals were obtained and digitally signed on or before May 31, 2017.

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Text version

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 TA19 1 50423-190A

Project Location: Project Name:

Dagny Johnson Key Largo Hammock Botanical SP Port B Restoration Consultant Name:

George & Associates Consulting Engineers, Inc Consultant Representative: Phone: Email:

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

Mae Roth 850-245-2781 mae.roth(a),dep.state.fl.us Description and Justification of Change:

New contractor requiring a pre-construction startup meeting and a 92 day extension of task assignment.

Ch angem as . T, kA mount:

Jtem R,eimbm;setneut !;�Fee Original Task Amount: $ 1.163.10 $ 25.062.84 Task amount including all previous Change Orders: $ L163.10 $25,062.84 Net increase/decrease in task amount for this Change Order: $ 1.610.76 Total Amounts with all Change Orders: $ 1.163.10 $26,673.60

Ch ange m as ,me: . T, k1'i"

Original Task Execution Date: 02/14/2017

Beth Haslage Budget Representative, FDEP

Paul Rice Project Manager, FDEP

Mae Roth

Original Task End Date: 05/31/2017

Present Task End Date: 05/31/2017

Net Change in Days: 92

New Task End Date: 08/31/2017

Approval Signatures:

Beth Ha. s I age Digitally signed by Beth Haslage Date: 2017.05.30 09:39:14 -04'00'

Signature

Paul Rice

Signature

Mae Roth

Signature

Digitally signed by Paul Rice Date: 2017.05.25 11 :29:56 -04'00'

Digitally signed by Mae Roth Date: 2017.05.31 0B:33:32-04'00'

Date

Date

Date

Total $26,225.94 $ 26.225.94 $ 1.610.76

$ 27 836.70

Contract Manager, FDEP

Robert George Robert George Digitally signed by Robert George Date: 2017.05.31 09:13:55 -04'00' 5/31/17

Consultant Signature

Michael W Foster Jr., P.E.

Contract Authority, FDEP Signature Date /

Proiect # Grant# On!Code Cat/Year Fund Module ObiectCode EO Amount

50423 3750-5018-190 080039-16 423001 U3200 134000 QK $1,610.76

29 Di2it FLAIR Code: 37-20-2-423001-3 7500300-00-080039-l 6 Total: $1,610.76

000- 012 (Effective 5-19-2016) Page 1 of 1

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