CN-370000-CN229-T22CO1.pdf
PDF 416 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 a project with Wantman Group (WGI), a consulting firm. The change order, numbered FDEP-BDC, pertains to Task Assignment No. 22 under FDEP Contract No. CN229. The project is located at Dr. Von D. Mizell-Eula Johnson State Park and involves Beach & Sand Improvements and Jetty Walkway work. Key personnel include S. Ken Widjaja, PE, SI from WGI as the Consultant Representative and Ralph Perkins as the FDEP Contract Manager. The document was approved by multiple FDEP officials including Budget Representative Tamika Bass, Project Manager Jim McGuire, Contract Manager Ralph Perkins, and Contract Authority Michael W. Foster Jr., P.E., with final approval dated October 2, 2024.
This change order represents a time extension only with no adjustment to the contract amount. The original task execution date was July 10, 2023, with an original end date of October 22, 2024. The change order extends the task end date by 365 days to October 22, 2025, to allow for administrative services. The total task amount remains unchanged at $40,984.98, comprising a reimbursement component of $665.34 and a fixed fee of $40,319.64. No net increase or decrease in task amount is associated with this change order. The extension was requested via email dated September 10, 2024, from WGI's Project Manager S. Ken Widjaja to accommodate ongoing administrative requirements for the project.
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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 22 FDEP-BDC 61482C
Dr. Von D. Mizell-Eula Johnson State Park Beach & Sand Improvements, Jetty Walkway 61200C
Wantman Group (WGI)
S. Ken Widjaja, PE, SI 561-687-2220 ken.widjaja@wginc.com
Ralph Perkins 850-245-2460 ralph.perkins@floridadep.gov
This is a time extension only request to allow for administrative services.
Please see the attached backup email dated 09/10/2024
$ 665.34 $ 40,319.64 $ 40,984.98 $ 665.34 $ 40,319.64 $ 40,984.98 $ 0.00 $ 0.00 $ 0.00
$ 665.34 $ 40,319.64 $ 40,984.98
07/10/2023
10/22/2024
10/22/2024
10/22/2025
Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2024.09.17 15:00:33 -04'00'
Jim McGuire Jim McGuire Digitally signed by Jim McGuire Date: 2024.09.18 08:12:13 -04'00'
Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2024.09.19 09:03:03 -04'00'
Jeffrey Bergman, PE 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: 2024.10.02 16:42:41 -04'00'
$ 0.00
File details come from the government source that posted it. Updated .