CN-370000-CN217-T34CO1.pdf
PDF 7 MB Posted
- Contract number
- CN217
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 1) issued by the Florida Department of Environmental Protection (FDEP) for Contract No. CN217, Task Assignment No. 34. The project involves Dade Battlefield Historic State Park Bandstand Repairs located in Dade City, Florida. The consultant performing the work is JGP Structural Group, Inc., represented by Jeffrey G. Parzych, PE, with FDEP Contract Manager Ralph Perkins overseeing the engagement. The change order was executed on September 29, 2022, with all required signatures obtained from FDEP budget, project management, and contract authority representatives, as well as the consultant.
The change order addresses additional services required due to discovered conditions at the project site, necessitating supplemental site visits and structural revisions to original drawings. The scope includes Subtask 2H & I (Additional Construction Administration Services) valued at $2,520.50 and Subtask 4 (Structural Modifications) valued at $6,381.05, for a combined change order total of $8,901.55 in reimbursable and fixed-fee costs. The net increase in the original task amount is $651.55 in reimbursable costs and $8,250.00 in fixed fees. The total task amount including all previous change orders reaches $18,512.16. The project execution and end dates remain December 15, 2022, with no extension of the timeline. Payment is contingent upon FDEP approval of deliverables for each subtask.
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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 34 1 61254C
Dade Battlefield Historic State Park Bandstand Repairs
JGP Structural Group, Inc.
Jeffrey G. Parzych, PE 850-574-2888 contact@jgpstructural.com
Ralph Perkins 850-245-2460 ralph.perkins@floridadep.gov
Due to discovered conditions, additional visits and structural revisions to the original drawings are required.
As per attached proposal dated July 29, 2022.
$ 600.75 $ 9,009.86 $ 9,610.61 $ 600.75 $ 9,009.86 $ 9,610.61 $ 651.55 $ 8,250.00 $ 8,901.55
$ 1,252.30 $ 17,259.86 $ 18,512.16
12/15/2022
12/15/2022
12/15/2022
12/15/2022
Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2022.08.26 11:51:36 -04'00'
John Goss John Goss Digitally signed by John Goss Date: 2022.09.13 07:41:06 -04'00'
Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2022.09.13 08:56:17 -04'00'
Jeffrey G. Parzych, PE Jeffrey Parzych Digitally signed by Jeffrey Parzych Date: 2022.09.23 14:30:42 -04'00'
Michael W. Foster, Jr., P.E. Michael W. Foster Jr., P.E.
Digitally signed by Michael W.
Foster Jr., P.E.
Date: 2022.09.29 14:52:50 -04'00'
61254C 37504000018 080039/22 423001 U3200 131500 QK $ 8,901.55
$ 8,901.55
| CN217 TA34 CO1 61254C Dade JGP 08042022 form.pdf |
| CN217 TA34 CO1 61254C Dade JGP 08042022 backup.pdf |
File details come from the government source that posted it. Updated .