CN-370000-CN230-T37CO3.pdf

Florida Department of Environmental Protection

TASK ASSIGNMENT CHANGE ORDER FORM

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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:

CN230 37 03 61366C

Don Pedro Island State Park Visitor Dock Repairs

Weiler Engineering Corporation

Robin Palmer 941.505.1700 rpalmer@weilerengineering.org

Ralph Perkins 850.245.2640 Ralph.Perkins@FloridaDEP.gov

Time only for permitting and design per the attached correspondence dated 11/16/23.

$ 1,181.00 $ 40,978.88 $ 42,159.88 $ 3,581.00 $ 42,478.88 $ 46,059.88

$ 0.00 $ 3,581.00 $ 42,478.88 $ 46,059.88

12/01/2021

06/30/2023

12/31/2023

04/29/2025

Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2023.11.27 09:39:37 -05'00'

Richard Marcil Richard Rene Marcil, III Digitally signed by Richard Rene Marcil, III Date: 2023.11.30 08:40:02 -05'00'

Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2023.11.30 12:52:12 -05'00'

Jeff Weiler, P.E. Jeff Weiler Digitally signed by Jeff Weiler Date: 2023.12.04 11:53:45 -05'00'

Michael W. Foster Jr., P.E. Michael W. Foster Jr., P.E.

Digitally signed by Michael W.

Foster Jr., P.E.

Date: 2023.12.11 16:02:53 -05'00'

61366C

$ 0.00

From: Robin Palmer To: Marcil, Richard Cc: Carron, Theresa Subject: Don Pedro Visitor Dock-CN 37 Request for Time Extension Date: Thursday, November 16, 2023 12:06:43 PM

EXTERNAL MESSAGE

This email originated outside of DEP. Please use caution when opening attachments, clicking links, or responding to this email.

Good afternoon Rene, TA 37 for the Don Pedro Visitor Dock Replacement expires on 12/31/2023. This project is still in permitting review with USACE so we are requesting a No Cost Time Extension (CO3) that extends to our continuing services end date of April 29, 2025. Please let me know if you have any questions.

Thank you, Robin Palmer, P.E.Environmental Engineer