CN-370000-GC892-T5CO2.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.

GC892-5 02 GC892

Restore performance incentives to exactly as represented in the Task Assignment that were previously removed in Change Order 1. Change amount $72,198.50.

David G. Warfel 850-245-8891 Contractor Contractor

Contractor Contractor

Contractor

City of Jacksonville Environmental and Compliance Allene Rachal 904-255-7139

Local Program Petroleum Cleanup Contracts

✔ $ 1,600,168.50 $ 1,527,970.00

$ 1,600,168.50 $ 1,527,970.00 ✔ Expiration

Expiration 0

Melissa M. Long, P.E.

Chief, Environmental Quality Division

Melissa M. Long Digitally signed by Melissa M. Long Date: 2021.06.21 14:08:09 -04'00' Leslie Reed Digitally signed by Leslie Reed

Date: 2021.06.25 14:58:11 -04'00'

450401002 JN 131545 37450300 104138 00 $ 72,198.50