CN-370000-CN220-T13CO2.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:

CN220 13 2 N2004

Gulf County, FL Highland View Boat Ramp Improvements

Dewberry Engineers, Inc

Deji Ajose-Adeogun, P.E. 850-523-0062 AAjose-Adeogun@Dewberry.com

Jack Brady 850-245-2535 Jack.Brady@FloridaDEP.gov

Extends the task end date to June 30, 2020 due to a delay in obtaining the FDOT Construction Agreement as required by the project.

$ 8,481.63 $ 8,481.63 $ 13,595.28 $ 13,595.28

$ 0.00 $ 0.00 $ 0.00 $ 13,595.28 $ 13,595.28

December 20, 2018

December 31, 2019

December 31, 2019

June 30, 2020

Janet Parramore Janet Parramore Digitally signed by Janet Parramore Date: 2019.12.13 10:05:57 -05'00'

Jim Oskowis, P.E. James J. Oskowis Digitally signed by James J.

Oskowis Date: 2019.12.12 13:48:40 -05'00'

Jack Brady Jack Brady Digitally signed by Jack Brady Date: 2019.12.13 13:15:46 -05'00'

Deji Ajose-Adeogun, PE Ayodeji Ajose-Adeogun Digitally signed by Ayodeji Ajose-Adeogun DN: C=US, E=aajose-adeogun@dewberry.com, O=Dewberry, CN=Ayodeji Ajose-Adeogun Date: 2019.12.13 13:38:46-05'00'

Phil Coram, P.E. Phillip Coram Digitally signed by Phillip Coram Date: 2019.12.13 15:04:38 -05'00'

$ 0.00

$ 0.0037202099005372201000008365412

Pigott, Carolyn

From: Ajose-Adeogun, Ayodeji <AAjose-Adeogun@Dewberry.com> Sent: Monday, December 9, 2019 11:21 AM To: Oskowis, Jim Cc: Pigott, Carolyn Subject: Task Assignment No. 13 for Contract CN220 (Extension)

Jim, This email serves as a formal request to extend the above referenced Task Assignment at no cost to 06/30/2020. The extension is necessary due a lengthy delay in obtaining the FDOT Construction Agreement and will allow Dewberry to continue providing construction management services until completion of the project.

Thanks, Deji Ajose‐Adeogun, PE Senior Project Manager Dewberry 850.354.5181

Visit Dewberry’s website at www.dewberry.com If you’ve received this email even though it’s intended for someone else, then please delete the email, don’t share its contents with others, and don’t read its attachments. Thank you.