CN-370000-CN217-T16CO2.pdf

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:

CN217 16 02 6i401

Hillsborough River SP Stationary Bridge

JGP Structural Group, Inc.

Jeff G. Parzych, P.E. 850.574.2888 jeff@jgpstructural.com

Alyssa Skehan 850-245-2781 Alyssa.Skehan@Floridadep.gov

Additional time to perform remaining project tasks per the attached email dated 02/22/2021.

$ 1,310.40 $ 26,660.00 $ 27,970.40 $ 1,310.40 $ 29,345.00 $ 30,655.40

$ 0.00 $ 0.00 $ 0.00 $ 1,310.40 $ 29,345.00 $ 30,655.40

7/15/20

3/30/2021

3/30/2021

9/27/21

Greg Turral Gregory Turral Digitally signed by Gregory Turral Date: 2021.02.23 09:18:13 -05'00'

Theresa Carron Theresa Carron Digitally signed by Theresa Carron Date: 2021.02.23 09:34:59 -05'00'

Alyssa Skehan Alyssa Skehan Digitally signed by Alyssa Skehan Date: 2021.02.23 09:40:46 -05'00'

Jeffrey G. Parzych, P.E. Jeffrey Parzych Digitally signed by Jeffrey Parzych Date: 2021.03.03 14:57:25 -05'00'

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

Digitally signed by Michael W.

Foster Jr., P.E.

Date: 2021.03.08 13:38:39 -05'00'

$ 0.00

Carron, Theresa

From: Jeffrey Parzych <jeff@jgpstructural.com> Sent: Monday, February 22, 2021 3:29 PM To: Carron, Theresa Subject: Re: Hills Ped Bridge Construction admin is expiring in March 2021

Theresa, Please consider this email as our official 'time only' change order request for extending CN217, TA16, Hillsborough River Stationary Bridge, project no. 6i401. Our current task assignment completion date is 03/30/2021, based on the anticipated construction schedule of 120 days and a 30 day allowance for final completion by the contractor, we request that the revised task assignment completion date be extended for an additional 181 days and changed to 09/27/2021. This provides an additional 31 days beyond the current end date of 03/30/2021 to engage the services of the successful bidder.

If you have any questions or require any further documentation please contact our office.

Respectfully, Jeffrey G. Parzych, PE Principal JGP Structural Group, Inc 1221 W. Tharpe Street Tallahassee, FL 32303 850.574.2888 850.445-0224 c

TALLAHASSEE/NAPLES-FT MYERS

On Fri, Feb 19, 2021 at 8:58 AM Carron, Theresa <Theresa.Carron@dep.state.fl.us> wrote:

Jeff, Can you please send an email request to add time only to this task assignment, the number of days, the new end date, and the reason for the request? I believe you will need this time to complete the construction administration services outlined in CN217 TA16 for the Hillsborough Stationary Bridge project, before the March 30, 2021 expiration of the task assignment.

Much appreciated!

Thank you, Theresa R. Carron

Department of Environmental Protection

Project Manager Bureau of Design and Construction

3800 Commonwealth Boulevard 260M, MS 520 Tallahassee, FL 32399 Theresa.Carron@FloridaDEP.gov O: (850) 245-2721

C: (850) 294-4642

This communication does not constitute an authorization for any increase in the scope of work, cost, or time for the project being discussed. All changes to services, cost, or time must be accomplished in accordance with the formal process outlined in the contract. The DEP objects to, and shall not be responsible for, any changes to services, costs, or additional time not authorized by an executed Contract Amendment, Task Assignment Change Order, Construction Change Order, or Construction Change Directive, as appropriate for this contract.

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