CN-370000-CN229-T25CO1.pdf
PDF 1 MB Posted
- Contract number
- CN229
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 1) issued by the Florida Department of Environmental Protection (FDEP) for Contract No. CN229, Task Assignment No. TA25. The consultant is WGI, Inc., with S. Ken Widjaja, P.E. serving as the consultant representative. The FDEP Contract Manager is Ralph Perkins. The project is located at Dr. Von D. Mizell-Eula Johnson State Park and involves the replacement residence at the Mechanic's Residence. The change order was signed on February 22, 2024, and is approved by all required FDEP authorities and the consultant.
The change order authorizes the design of temporary shoring for the existing deteriorated elevated concrete platform in the Mechanic's Residence to allow FDEP time to determine next steps regarding replacement. The contract scope includes three primary subtasks: Subtask 3 (Temporary Shoring Construction Document) with a fixed fee of $12,769.02; Subtask 4 (Construction Phase Services) with a fixed fee of $3,841.92; and Subtasks 5A-C (Construction Phase Services – Site Visits) with combined fixed fees of $3,591.00 and reimbursable costs of $148.20. The net increase in this change order is $20,350.14 in fixed fees and $148.20 in reimbursable costs. The total contract amount including all previous change orders is $34,018.62. The task execution date is November 2, 2023, with a task end date of May 11, 2026. Payment will be made upon FDEP approval of deliverables for each subtask.
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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 TA25 1 61548C
Replace Residence
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
The change is for a design of temporary shoring for the existing deteriorated elevated concrete platform in the Mechanic's Residence at Mizell-Johnson State Park. This will allow FDEP time to determine next steps regarding a replacement of the residence. Per attached dated 2/22/24
$ 0.00 $ 13,668.48 $ 13,668.48 $ 0.00 $ 13,668.48 $ 13,668.48
$ 148.20 $ 20,201.94 $ 20,350.14 $ 148.20 $ 33,870.42 $ 34,018.62
11/02/2023
05/11/2026
05/11/2026
05/11/2026
Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2024.02.22 14:27:08 -05'00'
Richard Marcil Richard Rene Marcil, III Digitally signed by Richard Rene Marcil, III Date: 2024.02.22 15:22:18 -05'00'
Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2024.02.22 15:47:52 -05'00'
Jeffrey Bergmann, P.E. Jeffrey R Bergmann Digitally signed by Jeffrey R Bergmann DN: CN=Jeffrey R Bergmann, dnQualifier=A01410C00000186932BC0D40000CB71, O=WGI INC, C=US
Date: 2024.02.23 11:20:22-05'00'
Michael W. Foster Jr., P.E. Michael W. Foster Jr., P.E.
Digitally signed by Michael W.
Foster Jr., P.E.
Date: 2024.02.26 09:55:34 -05'00'
61548C 37505000107 080039/24 675002 U3200 131500 XR $ 20,350.14
$ 20,350.14
Dr. Von D. Mizell-Eula Johnson State Park
File details come from the government source that posted it. Updated .