CN-370000-GC130-T10CO1.pdf

Funding Information:

Org. Code E.O. Object Code Budget Entity Appropriation

Category Grant # Project # Year Amount

☐ Additional Funding Information attached on separate page.

Rev. 8/17/2020

STATE OF FLORIDA

DEPARTMENT OF ENVIRONMENTAL PROTECTION

Task Assignment Change Order This Change Order is entered into between the Parties named below and amends the Task Assignment (TA) and any previous TA Change Orders (TACO) as follows:

1. TA Number: TACO Number: Contract Number:

TACO Description:

2. Parties State of Florida Department of Environmental Protection (Department)

Department’s Project Manager: Department’s Project Manager Phone:

Contractor Name: (Contractor ) ntractor’st ’s Project Manager: ontractor’s t’s Project Manager Phone:

3. Project Number:

(If different from TA Number) Project Name:

4. ☐ There are no changes to the TA compensation.

☐ The compensation of the TA is changed to the amounts indicated below:

Amended Price Price Prior to TACO ☐ Fixed Price:

☐ Fixed Unit Rate: (Extended Price)

☐ Cost Reimbursement:

Total TA Value:

5. ☐ There are no changes to the TA Expiration Date.

☐ The TA Completion Date is changed from ______________ to ______________ (a total of ______ days).

6. ☐ There are no changes to the Attachments.

☐ Attachment ___ is replaced with Attachment -____.

7. ☐ No Additional Changes.

☐ Additional Changes:

8. All other terms and conditions of the TA remain in effect. If and to the extent that any inconsistencies may appear between the TA and this TACO, the provisions of this TACO shall control.

IN WITNESS WHEREOF, this TACO shall be effective on the last date signed below.

State of Florida Department of Environmental Protection

CONTRACTOR Department Name:

Title: Director, Division of Waste Management

(Authorized Signature) (Authorized Signature) Date:

☐ Additional signatures attached on separate page.

10 1 GC130

Funding for additional tasked items

Robert Perlowski 8502458917 Contractor Contractor

Contractor Contractor

Contractor

NorthStar Contracting Group Kristy Trueblood 8502226446

Administrative Services

✔ $ 311,294.56 $ 293,171.26

$ 311,294.56 $ 293,171.26 ✔ Expiration

Expiration 0

NorthStar Contracting Group

Kristy Trueblood

Administrative Services Manager, NorthStar

Kristy Trueblood Digitally signed by Kristy Trueblood Date: 2024.08.06 13:22:35 -04'00'

Tim J. Bahr

Tim Bahr Digitally signed by Tim Bahr Date: 2024.08.06 15:51:14 -04'00'

450400000 JG 131545 37450300 087889 GC130 24 $ 18,123.30