CN-370000-CN229-T12CO6.pdf
PDF 323 KB Posted
- Contract number
- CN229
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) for contract CN229, Task Assignment TA12, Change Order CO6. The project involves The Barnacle Historic State Park Pavilion Replacement located in Florida. The consultant performing the work is WGI, Inc., represented by S. Ken Widjaja, P.E., with FDEP contract management by Ralph Perkins. The change order was approved by multiple FDEP representatives including the Budget Representative, Project Manager, and Contract Manager, with final authority granted by Michael W. Foster Jr., P.E.
The change order authorizes a time extension for the project with no adjustment to the task amount. The original task end date of April 30, 2021 has been extended to May 11, 2026, representing a net increase of 682 days. The total task amount remains at $88,427.72, consisting of $318.62 in reimbursable expenses and $88,109.10 in fixed fees. The change order was executed on April 23, 2024, based on WGI's request dated April 17, 2024, to allow additional time necessary for project completion. All required signatures were obtained, with the Contract Authority signature dated May 7, 2024.
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Text version
Florida Department of Environmental Protection
TASK ASSIGNMENT CHANGE ORDER FORM
( ) 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:
CN229 TA12 CO6 61271C
The Barnacle Historic State Park Pavilion Replacement
WGI, Inc.
S. Ken Widjaja, P.E. 561-268-5681 ken.widjaja@wginc.com
Ralph Perkins or successor 850-245-2460 ralph.perkins@floridadep.gov
To allow time for additional work, a time extension has been requested per the attached dated April 17, 2024.
$ 284.80 $ 56,120.62 $ 56,405.42 $ 318.62 $ 88,109.10 $ 88,427.72 $ 0.00 $ 0.00 $ 0.00
$ 318.62 $ 88,109.10 $ 88,427.72
06/08/2020
04/30/2021
6/28/2024
05/11/2026
Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2024.04.23 09:56:01 -04'00'
Richard Marcil Richard Rene Marcil, III Digitally signed by Richard Rene Marcil, III Date: 2024.04.23 13:46:58 -04'00'
Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2024.04.23 22:58:53 -04'00'
Jeffrey Bergmann, P.E. Jeffrey R Bergmann Bergmann Date:
Michael W. Foster Jr., P.E. Michael W. Foster Jr., P.E.
Digitally signed by Michael W.
Foster Jr., P.E.
Date: 2024.05.07 10:26:04 -04'00'
$ 0.00
Jeffrey R Bergmann
Jeffrey R Bergmann Date:
File details come from the government source that posted it. Updated .