CN-370000-CN230-T53CO2.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 53 02 61397C

Dr. Von D. Mizell - Eula Johnson State Park Restroom Improvements

Weiler Engineering Corporation

Robin Palmer 941-505-1700 rpalmer@weilerengineering.org

Ralph Perkins 850-245-2640 Ralph.Perkins@FloridaDEP.gov

This is a no cost time only extension request to allow for the completion of permitting and construction administration services. Please see the attached back up dated 11/08/2024.

$ 2,823.20 $ 94,173.12 $ 96,996.32 $ 2,823.20 $ 104,388.92 $ 107,212.12

$ 0.00 $ 0.00 $ 0.00 $ 2,823.20 $ 104,388.92 $ 107,212.12

1/23/23

11/30/24

11/30/24

04/25/2025

Tamika Bass Tamika Bass Digitally signed by Tamika Bass Date: 2024.11.12 10:17:48 -05'00'

Jim McGuire Jim McGuire Digitally signed by Jim McGuire Date: 2024.11.15 09:31:01 -05'00'

Ralph Perkins Ralph M Perkins Digitally signed by Ralph M Perkins Date: 2024.11.15 09:36:11 -05'00'

R. Jeff Weiler, PE Jeff Weiler Digitally signed by Jeff Weiler Date: 2024.11.22 16:03:47 -05'00'

Bryan Bradner Bryan Bradner Digitally signed by Bryan Bradner Date: 2024.11.26 13:46:08 -05'00'

$ 0.00

PUNTA GORDA OFFICE: 201 WEST MARION AVENUE - SUITE 1306 | PUNTA GORDA | FL 33950 | TEL 941-505 -1700 | FAX 941-505 -1702 MARATHON OFFICE: 6805 OVERSEAS HIGHWAY | MARATHON | FL 33050 | TEL 305 -289-4161 | FAX 305 -289-4 1 6 2 WE INVITE YOU TO VISIT OUR WEB SITE AT WWW.WEILERENGINEERING.ORG OR EMAIL US AT INFO@WEILERENGINEERING.ORG

November 8, 2024

Michele Mitchell Assistant Project Manager

Bureau of Design and Construction Florida Department of Environmental Protection

Re: Dr. Von D. Mizell-Eula Johnson State Park- Restroom Improvements FDEP Contract No: CN230 Task Assignment No: 53, Project No: 61397C

Ms. Mitchell, We are requesting a time extension for the Dr. Von D. Mizell-Eula Johnson State Park- Restroom Improvements project. This extension would be at no additional cost to the FDEP. The current contract expires on 11/30/2024. We are requesting an extension until 4/25/2025 to allow enough time for the construction to be completed.

If you have any questions, or require additional information, please do not hesitate to contact me at (941) 505-1700 or electronically at rpalmer@weilerengineering.org.

Sincerely, Robin Palmer, P.E.

Project Manager Weiler Engineering Corporation