CN-370000-CN220-T7CO2.pdf
PDF 680 KB Posted
- Contract number
- CN220
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection (FDEP) for Contract No. CN220, Task Assignment No. TA07, Change Order No. CO2. The consultant on this contract is Dewberry Preble-Rish, represented by Deji Ajose-Adeogun, P.E. The project, titled "GTM preserve exhibits," is located at the GTM Environmental Education Center. The FDEP Contract Manager is Adam Browne. All required signatures from FDEP personnel (Budget Representative Lisa Yarborough, Project Manager Brian Miller, Contract Manager Adam Browne, and Contract Authority Michael Shirley, Director, PhD) and the consultant representative were obtained on June 26-27, 2018.
This change order represents a time extension only, with no change to the reimbursement or fixed fee amounts. The original task amount was $10,138.26, and with all previous change orders, the total task amount remains $13,180.29. The change order adds 184 days to the original task schedule, extending the task end date from December 31, 2017, to December 31, 2018, to allow the consultant's Construction Administration services to be utilized during the construction phase. The net increase in task amount is $0.00, with all costs funded through FDEP's budget allocation using FLAIR Code 37202261019375004000010208000, which carries a total budgeted amount of $0.00 for this particular change order.
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Text version
Florida Department of Environmental Protection
TASK ASSIGNMENT CHANGE ORDER FORM
OOO – 012 (Effective 5-19-2016) 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 TA07 CO2 N/A
GTM Environmental Education Center GTM preserve exhibits
Dewberry Preble-Rish
Deji Ajose-Adeogun 850-523-0062 AAjose-Adeogun@Dewberry.com
Adam Browne 850-245-2466 Adam.Browne@dep.state.fl.us
Time extension only so that consultant's Construction Administration services may be utilized during the construction phase of the project.
$ 0.00 $ 10,138.26 $ 10,138.26 $ 0.00 $ 13,180.29 $ 13,180.29 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 13,180.29 $ 13,180.29
3/14/17
12/31/17
6/30/18
12/31/18
Lisa Yarborough 6/26/18
Brian Miller 6/26/18
Adam Browne 6/26/18
Deji Ajose-Adeogun, P.E.
Michael Shirley, Director, PhD
NA GTMCG 37538060000 102080 261019 U4220 242000 LH $ 0.00
$ 0.0037202261019375004000010208000
Lisa Yarborough Digitally signed by Lisa Yarborough Date: 2018.06.26 11:39:01 -04'00'
Brian Miller Digitally signed by Brian Miller Date: 2018.06.26 12:43:29 -04'00'
Adam B. Browne Digitally signed by Adam B.
Browne Date: 2018.06.26 14:19:49 -04'00'
Michael A. Shirley Digitally signed by Michael A.
Shirley Date: 2018.06.27 08:39:18 -04'00'
Ayodeji Ajose-Adeogun Digitally signed by Ayodeji Ajose-Adeogun DN: C=US, E=aajose-adeogun@dewberry.com, O=Dewberry|Preble Rish, CN=Ayodeji Ajose-Adeogun Date: 2018.06.26 17:35:47-04'00'
File details come from the government source that posted it. Updated .