CN-370000-GC130-T9CO1.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:

Secretary or Designee

(Authorized Signature) (Authorized Signature) Date:

Additional signatures attached on separate page.

9 1 GC130

Funding for additional tasked items

Robert Perlowski 8502458917 Contractor NorthStar Contracting Group Contractor

Contractor Kristy Trueblood Contractor 8502226446

Administrative Services

✔ $ 1,553,285.80 $ 1,457,414.46

$ 1,553,285.80 $ 1,457,414.46 ✔ Expiration

Expiration 0

Contractor Kristy Trueblood

Administrative Services Manager, NorthStar

10/31/2023

Kristy Trueblood Digitally signed by Kristy Trueblood Date: 2023.10.31 12:51:03 -04'00'

Anna DeCerchio

12/11/2023

37450404555 JG 131545 37450300 087889 GC130 23 $ 95,871.34

Anna DeCerchio Digitally signed by Anna DeCerchio Date: 2023.12.11 13:36:12 -05'00'

Itemized Description of Change

Funding Information: Petroleum Restoration Program

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

Category Grant # Project # Year Price Prior to

TACO

Change Amount

Amended Amount

37450404555 JG 131545 37450300 087889 GC130 23 $1,457,414.46 $95,871.34 $1,553,285.80 Scope of Work Description # of Deliverables Unit Price Total

Additions In Funding Task 5 PCPP LCAR Solicitation and Tracking 195 $130.19 $25,387.05

Task 7A Initial SAA Letters 100 $135.38 $13,538.00 Task 7B Follow-up SAA Letters 500 $12.99 $6,495.00 Task 7D Eligibility Rescission Orders 33 $41.36 $1,364.88 Task 8B Follow-up PCPP/LCAR Letters 300 $49.15 $14,745.00 Task 8C Self Addressed Stamped Envelopes (SASE) PCPP/LCAR 40 $1.75 $70.00 Task 8D Processing and Tracking of Certified Mail Return Receipt Requested PCPP/LCAR 25 $12.65 $316.25 Task 14B CCA Application Processed to Completion 40 $408.14 $16,325.60 Task 14C CCA Deed Recording Electronic 40 $393.71 $15,748.40 Task 14D CCA Deed Recording Electronic - additional pages 140 $11.00 $1,540.00 Task 14F CCA Deed Recording Mailed - additional pages 8 $16.00 $128.00 Task 15 Database Analyst - Staff Level (Contractor Housed) 4 $53.29 $213.16

Change in Program Area Funding $95,871.34

Change in Task Assignment Funding Price Prior to

TACO

Change Amount

Amended Amount

$1,457,414.46 $95,871.34 $1,553,285.80