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 53 FDEP-BDC 61479C

Troy Spring State Park Repair Spring Access Ramp

JGP Structural Group

Jeff Parzych, P.E. (850) 574-2888 jeff@jgpstructural.com

Ralph Perkins (850) 245-2460 Ralph.Perkins@FloridaDEP.gov

Professional services including geotech, survey, structural design, permitting, and construction administration to provide documents to replace the spring access ramp per the attached proposal dated 3/21/2023.

Theresa Carron

Upon Execution $ 53,911.89 3/21/2025 $ 733.36

$ 54,645.25

Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2023.03.28 13:03:47 -04'00'

Theresa Carron T.Carron Digitally signed by T.Carron Date: 2023.03.28 13:06:41 -04'00'

Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2023.03.28 13:20:31 -04'00'

Jeff Parzych, PE Jeffrey Parzych Digitally signed by Jeffrey Parzych Date: 2023.03.28 18:40:03 -04'00'

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

Digitally signed by Michael W.

Foster Jr., P.E.

Date: 2023.03.31 15:23:09 -04'00'

61479C 37502000243 080039/23 423001 U3200 134000 QK $ 54,645.25

$ 54,645.25