CN-370000-GC714-T22CO1.pdf

This document is a Task Assignment Change Order Form (Attachment B) for DEP Contract No. GC714, dated April 10, 2012. The change order involves the Florida Department of Environmental Protection and York Risk Services Group, Inc. of Florida (FEIN 59-3124034). The contractor's representative is Brian King, and the DEP Contract Manager is Ashli Harvey. This change order pertains to Task Assignment #22 covering Scopes 1, 2, 3, and 4 under an Administrative Services Contract.

Task #22 is being increased by $56,250.00 in total value through this change order, comprised of CDF Validation services at $125.00 for 250 additional units ($31,250.00) and CDF Requests at $125.00 for 200 additional units ($25,000.00). The original task amount was $571,250.00, and with this change order, the total task amount becomes $627,500.00. The task completion date remains June 30, 2012 with no extension to the task period. Funding is allocated from Organization Code 37450404555 under Work Order 1139950, Module 4713, Fund 1087888 for Fiscal Year 2011-12 in the amount of $56,250.00. The change order was approved by the Budget Representative and the Chief, Bureau of Petroleum Storage Systems on April 9, 2012.