CN-370000-GC896-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.

GC896-5 02 GC896

Restore performance incentives to exactly as represented in the Task Assignment that were previously removed in Change Order 1.Change Amt $22,900.

David G. Warfel 850-245-8891 Contractor Contractor

Contractor Contractor

Contractor

Board of County Commissioners Palm Beach County Deborah Drum 561-233-2400

Local Program Petroleum Cleanup Contracts

✔ $ 501,900.00 $ 479,000.00

$ 501,900.00 $ 479,000.00 ✔ Expiration

Expiration 0

Deborah Drum

Department Director, Environmental Res. Mgmt.

6-21-2021

Digitally signed by Deborah Drum DN: DC=org, DC=pbcgov, OU=Enterprise, OU=ERM, OU=Users, CN=Deborah Drum, E=DDrum@pbcgov.org Reason: I am approving this document Location: your signing location here Date: 2021.06.21 16:13:19-04'00' Foxit PhantomPDF Version: 10.1.0

Deborah Drum

John Truitt, Deputy Secretary of Regulatory Programs

John Truitt Digitally signed by John Truitt Date: 2021.06.24 13:48:22 -04'00'

6/24/2021

450401002 JN 131545 37450300 104138 00 $ 22,900.00

SAStone Typewritten Text Approved as to form and legal sufficiency:

/s/______________________________ Scott A. Stone, Assistant County Attorney

SAStone Stamp