CN-370000-CN217-T12CO1.pdf
PDF 3 MB Posted
- Contract number
- CN217
- 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 a historic structure repair project. The change order involves FDEP as the state agency, JGP Structural Group, Inc. as the primary consultant, and Professional Services Industries, Inc. (PSI) as a subcontractor. The project concerns the repair of the historic bandstand (gazebo) at Dade Battlefield State Park in Dade Battlefield, Florida. The change order is identified as Change Order No. 1 for Task Assignment No. 12 under FDEP Contract No. CN217, with Project No. 61254C.
The change order authorizes additional construction phase time and professional services for asbestos and lead-based paint surveying and reporting. Subtask 6 covers asbestos and lead paint testing at a fixed price cost of $2,783.58, comprised of JGP Structural Group coordination services ($790.00) and PSI testing services ($1,993.58). Subtask 7 covers roof strengthening design revisions by JGP Structural Group at a fixed price cost of $1,955.00. The total net increase for this change order is $4,738.58, bringing the cumulative task amount from $13,879.74 to $18,618.32. The original task end date of December 30, 2020 is extended by 150 calendar days to May 29, 2021. All deliverables are subject to FDEP review and approval before payment is authorized.
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Text version
Florida Department of Environmental Protection
TASK ASSIGNMENT CHANGE ORDER FORM
( ) 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:
CN217 12 1 61254C
Dade Battlefield Repair Historic Bandstand
JGP Structural Group, Inc.
Jeffrey G. Parzych, P.E. 850-574-2888 jeff@jgpstructural.com
Philip Stone 850-245-2570 Philip.Stone@FloridaDEP.gov
Additional construction phase time, and professional services with Asbestos and Lead-Based Paint survey and report per the attached proposal dated 7/30/2020.
$ 919.80 $ 12,959.94 $ 13,879.74 $ 919.80 $ 12,959.94 $ 13,879.74
$ 4,738.58 $ 4,738.58 $ 919.80 $ 17,698.52 $ 18,618.32
8/22/2019
12/30/2020
12/30/20
5/29/2021
Greg Turral Gregory Turral Digitally signed by Gregory Turral Date: 2020.08.10 17:34:31 -04'00'
Theresa Carron Theresa Carron Digitally signed by Theresa Carron Date: 2020.08.11 08:32:37 -04'00'
Philip Stone P.T. Stone Digitally signed by P.T. Stone Date: 2020.08.26 09:17:22 -04'00'
Jeffrey G. Parzych, P.E. Jeffrey Parzych Digitally signed by Jeffrey Parzych Date: 2020.08.26 14:35:31 -04'00'
Michael W. Foster Jr., P.E. Michael W. Foster Jr., P.E.
Digitally signed by Michael W.
Foster Jr., P.E.
Date: 2020.08.28 15:18:37 -04'00'
61254C 37504000018 080039/21 423001 U3200 131500 QK $ 4,738.58
$ 4,738.58
File details come from the government source that posted it. Updated .