CN-370000-GC704-T15.pdf
PDF 405 KB Posted
- Contract number
- GC704
- Issued by
- Florida
About this file
This is a Task Assignment Notification Form (Attachment B) for a Florida Department of Environmental Protection (FDEP) contract with Madison County under DLP Contract No. GC 704, Task No. 15. The document establishes a compliance inspection and maintenance services agreement effective from the execution date through June 30, 2017. The contract involves the FDEP as the state agency, with David Graham serving as the Contractor Task Manager and Mark Gillman as the DEP Task Manager.
The contractor shall conduct routine compliance inspections at 20 designated facilities within Jefferson County, perform re-inspections per Guidance Document A, and utilize a new Contractual Services Invoice Form for monthly billing. Compensation occurs on a monthly basis with invoices due no later than the 15th of the following month, as specified in the attached Payment Calculation Sheet. The funding allocation is $12,036.16 from Organization Code 3745030500 (JD), Object Code 132500, Module 4562, Special Category IPTF 100029 for Fiscal Years 16-17. The fee schedule includes routine inspections at $464.00 and various specialized services ranging from $190.11 to $1,140.68 per inspection type, including UST system installations, closures, AST system work, complaints, discharge inspections, and enforcement actions. The contractor must submit signed invoices with verified Payment Calculation Sheets, FIRST Reports, and monthly tracking forms documenting the percentage of routine inspections completed. Facility substitutions are permitted with department authorization via STRInvoices@dep.state.fl.us.
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Other files
| File | Type | Posted |
|---|---|---|
| CN-370000-GC704-T14.pdf | ||
| CN-370000-GC704-T5.pdf | ||
| CN-370000-GC704-T6CO1.pdf | ||
| CN-370000-GC704-T10.pdf | ||
| CN-370000-GC704-T3.pdf | ||
| CN-370000-GC704-A2.pdf | ||
| CN-370000-GC704-T13.pdf | ||
| CN-370000-GC704-CO001.pdf | ||
| CN-370000-GC704-T6.pdf | ||
| CN-370000-GC704-T4.pdf | ||
| CN-370000-GC704-T12.pdf | ||
| CN-370000-GC704-A1.pdf | ||
| CN-370000-GC704.pdf | ||
| CN-370000-GC704-T7.pdf | ||
| CN-370000-GC704-T17.pdf | ||
| CN-370000-GC704-T11.pdf | ||
| CN-370000-GC704-T14CO1.pdf | ||
| CN-370000-GC704-T9.pdf | ||
| CN-370000-GC704-T1.pdf | ||
| CN-370000-GC704-CO2.pdf | ||
| CN-370000-GC704-T2.pdf | ||
| CN-370000-GC704-T7CO1.pdf | ||
| CN-370000-GC704-T16.pdf |
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Text version
Date
Value Quantity 464.00$
CONTRACTUAL SERVICES INVOICE
Payment Calculations
Invoice No. Contract No. Task No. Invoice Period
Inspection Type Routine
List of Facilities (FAC. ID only) Attach FIRST spreadsheet
AST Piping Closure
AST System Closure
Complaint
Discharge
190.11$
570.34$
190.11$
UST System Install
UST Piping Install
Component Install
UST System Closure
UST Piping Closure
Component Closure
AST System Install
AST Piping Install
1,140.68$
380.23$
190.11$
760.45$
380.23$
190.11$
380.23$
190.11$
190.11$
190.11$
190.11$
Enforcement
Non-Compliance
TOTAL
Signature Date
FACILITY_ID NAME DISTRICT COUNTY FACSTAT FACTYPE ANNUAL_INSPECTIONC_TOTAL_UC_TOTAL_A ADDRESS1 CITY ZIP5 8518838 S&M FOOD MART NWD 33 OPEN A 2/28/2015 1 0 1546 N JEFFERSON ST MONTICELLO 32344 8509741 PIC N CHIC NWD 33 OPEN A 2/28/2015 3 0 1010 N JEFFERSON ST MONTICELLO 32344
9045876 MCI NWD 33 OPEN C 6/20/2015 1 0 821 OLD DRIFTON RD MONTICELLO 32344
9045675 RAJ FOOD STORE NWD 33 OPEN A 6/25/2015 1 0 700 E WASHINGTON ST MONTICELLO 32344 8509718 INTERSTATE 10 TRAVEL CENTRE NWD 33 OPEN A 6/25/2015 2 0 24 PAFFORD RD MONTICELLO 32336 8509733 GRANTS SERVICE CTR NWD 33 OPEN A 6/25/2015 2 0 1270 N JEFFERSON ST MONTICELLO 32344 8509757 THOMPSON GAS STATION NWD 33 OPEN A 6/25/2015 5 0 1210 N JEFFERSON ST MONTICELLO 32344
8509745 REAMS STORE NWD 33 OPEN A 6/26/2014 0 1 10075 S SALT RD LAMONT 32336
9200106 I‐10 PECAN HOUSE NWD 33 OPEN A 1/30/2015 0 3 323 S SALT RD MONTICELLO 32344 9300074 FL DEPT OF CORRECTIONS‐JEFFERSON C I NWD 33 OPEN G 2/13/2015 0 5 1050 BIG JOE RD MONTICELLO 32344 9301048 FAIRCHILD FL CONSTRUCTION CO NWD 33 OPEN C 2/28/2015 0 2 59 FAIRCHILD MONTICELLO 32344 9804079 XPO LOGISTICS FREIGHT, INC‐ NTH NWD 33 OPEN C 2/28/2015 0 1 285 INDUSTRIAL PARK MONTICELLO 32344 9805922 HARRIS WAUKEENAH X904 NWD 33 OPEN C 2/28/2015 0 1 1061 ST AUGUSTINE RD MONTICELLO 32344 9805944 HARRIS DISALVO X912 NWD 33 OPEN C 2/28/2015 0 1 310 N WAUKEENAH ST MONTICELLO 32344 8518811 JEFFERSON CNTY ROAD DEPT NWD 33 OPEN I 3/14/2015 0 2 1484 S JEFFERSON ST MONTICELLO 32344 9806672 JEFFERSON COUNTY HIGH SCHOOL NWD 33 OPEN C 3/14/2015 0 1 50 DAVID RD MONTICELLO 32344 8509747 AMERICAN ENERGY DISTRIBUTION CORP NWD 33 OPEN D 6/25/2015 0 4 383 YORK ST MONTICELLO 32344 9600783 JEFFERSON CNTY SCHOOL BD‐JAMES BOLAND NWD 33 OPEN I 6/25/2015 0 1 1780 S JEFFERSON ST MONTICELLO 32344 8509767 BOLAND TIMBER CO NWD 33 OPEN C 7/2/2015 0 1 12493 GAMBLE RD WACISSA 32361 9400135 WAUKEENAH FERTILIZER & FARM NWD 33 OPEN M 7/2/2015 0 1 9643 WAUKEENAH HWY MONTICELLO 32344
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