CN-370000-CN217-T29CO1.pdf
PDF 5 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 project involving JGP Structural Group, Inc. The change order, numbered 1, modifies Task Assignment No. 29 under FDEP Contract No. CN217 for the Cayo Costa State Park Dock Repair project (Project No. 61335C). The consultant representative is Jeffrey Parzych, P.E., and the FDEP Contract Manager is Ralph M Perkins. The change order was approved by multiple FDEP officials including Budget Representative Diane Langston, Project Manager Andrew Lippens, Contract Manager Ralph M Perkins, and Contract Authority Michael W. Foster Jr., P.E.
The change order constitutes a time-only extension of the task assignment for an additional 365 days, with no adjustment to the financial terms. The original task execution date of June 1, 2021, and original end date of June 30, 2022, are extended to June 29, 2023. The total task amount remains unchanged at $33,871.10, consisting of $658.60 in reimbursable expenses and $33,212.50 in fixed fees. The net increase to the contract amount is $0.00. JGP Structural Group requested the extension due to the sea grass survey work being time-dependent with the growing season, necessitating completion of the survey work required for the dock repair design. The change order was executed on June 29, 2022.
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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:
CN217 29 1 61335C
Cayo Costa State Park Dock Repair
JGP Structural Group, Inc.
Jeffrey Parzych, P.E. 850-574-2888 jeff@jgpstructural.com
Ralph M Perkins 850-245-2460 Ralph.Perkins@FloridaDEP.gov
Time only extension of task assignment for an additional year, per attached proposal dated 05/26/2022.
$ 658.60 $ 33,212.50 $ 33,871.10 $ 658.60 $ 33,212.50 $ 33,871.10 $ 0.00 $ 0.00 $ 0.00
$ 658.60 $ 33,212.50 $ 33,871.10
06/01/2021
06/30/2022
06/30/2022
06/29/2023
Diane Langston Diane Langston Digitally signed by Diane Langston Date: 2022.05.31 08:00:36 -04'00'
Andrew Lippens Andrew Lippens Digitally signed by Andrew Lippens Date: 2022.05.31 08:58:03 -04'00'
Ralph M Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2022.06.28 15:47:44 -04'00'
Jeffrey Parzych, P.E. Jeffrey Parzych Digitally signed by Jeffrey Parzych Date: 2022.06.28 16:19:21 -04'00'
Michael W. Foster Jr., P.E. Michael W. Foster Jr., P.E.
Digitally signed by Michael W.
Foster Jr., P.E.
Date: 2022.06.29 09:04:16 -04'00'
$ 0.00
| BLANK TA CO FORM.pdf |
| Cayo Costa Time ExtLtr.pdf |
File details come from the government source that posted it. Updated .