Florida Department of Environmental Protection

TASK ASSIGNMENT NOTIFICATION FORM

Required Signatures: Adobe Signature

FDEP Contract No.: Task Assignment No.: Owner’s Name: Project No.:

Project Location: Project Name:

Consultant Name:

Consultant Representative: Phone: Email:

FDEP Contract Manager: Phone: Email:

Description of Task:

Project Manager:

Schedule Start Date: Fixed Price Cost:

Completion Date: Cost Reimbursement not to exceed:

Total Task Amount:

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 28 FDEP 61333

Delnor Wiggins State Park Boardwalk Repair

JPG Structural Group, Inc

Jeffery Parzych PE 850.574.2888 jeff@jgpstructural.com

Alyssa Skehan or successor 850-245-2781 Alyssa Skehan@FloridaDEP.gov

Consultant to perform on-site field verification of existing structure/s and use this information to provide design and permit documents for the repair of the boardwalk as per the proposal dated 3/25/2021.

Wayne Thomas

Upon execution $ 12,495.00 6/30/2022 $ 402.17

$ 12,897.17

Greg Turral Gregory Turral Digitally signed by Gregory Turral Date: 2021.03.29 18:54:55 -04'00'

Wayne Thomas Wayne Thomas Digitally signed by Wayne Thomas Date: 2021.03.30 08:33:33 -04'00'

Alyssa Skehan Alyssa Skehan Digitally signed by Alyssa Skehan Date: 2021.03.30 10:58:56 -04'00'

Jeffery Parzych PE Jeffrey Parzych Digitally signed by Jeffrey Parzych Date: 2021.03.31 09:30:37 -04'00'

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

Digitally signed by Michael W.

Foster Jr., P.E.

Date: 2021.04.05 13:34:20 -04'00'

61333 37504000091 088130/21 675002 U3200 131500 XR $ 12,897.17

$ 12,897.17