CN-370000-CN304-T13CO1.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:

Phone:

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:

CN304 13 1 61336C

Paynes Prairie State Park AmeriCorps Modular Office / Pole Barn

Greenman Pedersen, Inc

Tim Stackhouse 850-2972948 tstackhouse@gpinet.com FDEP Contract Manager:

David Matson 850-245-2594

Email:

David.Matson@floridadep.gov

The intent being to address wetland delineations brought to our attention by SJRWMD and extend contract.

See the attached for time extension and additional services 5/26/22

$ 56,989.96 $ 56,989.96 $ 56,989.96 $ 56,989.96 $ 4,071.95 $ 4,071.95

$ 0.00 $ 61,061.91 $ 61,061.91

6/09/30

6/30/22

6/30/22

9/30/22

Diane Langston

Garland Sandel

David Matson

Tim Stackhouse

Michael W. Foster Jr., P.E.

61336C 37500200092 080039/21 408001 U3100 131500 PF $ 4,071.95

$ 4,071.95

Michael W. Foster Jr., P.E.

Digitally signed by Michael W.

Foster Jr., P.E.

Date: 2022.06.01 12:55:20 -04'00'

Sandel, Garland

From: Tim Stackhouse <tstackhouse@gpinet.com> Sent: Thursday, May 26, 2022 10:03 AM To: Sandel, Garland Subject: Payne's Prairie - Modular Office - Contract Extension request (CN304 - TA13)

EXTERNAL MESSAGE

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

Good Morning Garland, We would like to formally request a 90 day extension on our Payne�s Prairie Contract � (CN304 Task Assignment 13) Project # 61336C

Expected to expire 6/30/22 New expiration date would be 9/30/22

The intent being to address wetland delineations brought to our attention by SJRWMD.

Tim Stackhouse, P.E., LEED AP ND Senior Project Manager

1590 Village Square Boulevard, Tallahassee, FL 32309 d 850.297.2948 | c 321.698.3970 tstackhouse@gpinet.com | www.gpinet.com

An Equal Opportunity Employer

Per Title VI of the Civil Rights Act of 1964 and other Nondiscrimination statutes, Greenman Pedersen, Inc. and its related companies will not discriminate on the grounds of race, color or national origin in the selection and retention of subconsultants, including procurement of materials and leases of equipment. Greenman Pedersen, Inc. and its related companies will ensure that minorities will be afforded full opportunity to submit proposals and will not be discriminated against in consideration for an award.

This communication and any attachments are intended only for the use of the individual or entity named as the addressee. It may contain information which is privileged and/or confidential under applicable law. If you are not the intended recipient or such recipient's employee or agent, you are hereby notified that any dissemination, copy or disclosure of this communication is strictly prohibited and to notify the sender immediately.

Matson_D Text Box

CN304 TA13 CO1

Billing Summary:

Subtotal for Task 8:

Subtotal for Optional Task 9 : Subtotal for Task10:

Total Lump Sum Billing

Assumptions/Exclusions:

l. Any service not specifically described above is not included in this proposal.

2. This change order assumes no modification to the current design.

2,502.18 945.99 623.78

4,071.95

By: ______________ _ Authorized Representative of Florida Department of Environmental Protection (FDEP)

CiPI