CN-370000-CN214-T36CO2.pdf
PDF 1 MB Posted
- Contract number
- CN214
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) for contract CN214, Task Assignment No. 36. The change order was issued to George & Associates, a consulting engineering firm, with Project Engineer Signe Ulsamer serving as the consultant representative. FDEP Contract Manager Ralph Perkins oversaw the modification, which was approved by FDEP Budget Representative Tamika Bass, Project Manager Jasper Gebhardt, Contract Manager Ralph Perkins, and Contract Authority Michael W. Foster, Jr. on December 18, 2023.
The change order is a 365-day time-only contract extension for Construction Administration services related to the Silver Springs State Park Water Plant Modifications project (Project No. 61412C). The extension was necessary because the construction project was not anticipated to be completed by the original task end date of December 31, 2023. The contract extension maintains the same financial amounts established in the original task assignment, with no net increase or decrease in task amount: Reimbursement of $1,338.20 and Fixed Fee of $23,605.96, for a total of $24,944.16. The original task execution date was March 4, 2022, and the new task end date following this 366-day extension is December 31, 2024.
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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:
CN214 36 2 61412C
Silver Springs State Park Water Plant Modifications
George & Associates
Robert George 850-521-0344 rgeorge@gaceng.net
Ralph Perkins 850-245-2460 ralph.perkins@FloridaDEP.gov
365-day time-only contract extension to utilize Construction Administration services. See attached dated 11/29/23.
$ 1,338.20 $ 23,605.96 $ 24,944.16 $ 1,338.20 $ 23,605.96 $ 24,944.16
$ 0.00 $ 0.00 $ 0.00 $ 1,338.20 $ 23,605.96 $ 24,944.16
03/04/2022
12/31/2022
12/31/2023
12/31/2024
Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2023.12.14 15:25:30 -05'00'
Jasper Gebhardt Jasper Gebhardt Digitally signed by Jasper Gebhardt Date: 2023.12.14 17:03:26 -05'00'
Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2023.12.15 12:25:32 -05'00'
Brian Miller Brian Miller Digitally signed by Brian Miller Date: 2023.12.15 16:08:02 -05'00'
Michael W. Foster, Jr. Michael W. Foster Jr., P.E.
Digitally signed by Michael W.
Foster Jr., P.E.
Date: 2023.12.18 15:43:26 -05'00'
$ 0.00
Robinson_MS Text Box
| CN214 TA36 CO2 Silver Springs Water Plant Modifications.pdf |
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