CN-370000-GC897-T4CO1.pdf
PDF 876 KB Posted
- Contract number
- GC897
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 01) issued by the Florida Department of Environmental Protection on March 9, 2020, under existing contract GC897 between the State of Florida Department of Environmental Protection and the Florida Department of Health Pinellas County. The document is executed by contractor representative Charles Minor and DEP Contract Manager David G. Warfel, with approvals from Griffin Kolchakian (Budget Representative), John Truitt (Deputy Secretary), and Justin Wolfe (Secretary).
The change order authorizes work to be performed on an additional 31 sites within Pinellas County under the existing GC897 Task Assignment 4. The net increase in task funding is $85,650.00, comprised of additional authorization of $97,650 (31 sites × $3,150 per site) with a corresponding reduction of $12,000 in budgeted Incentive Payments. The task completion date remains June 30, 2020, with no extension of the performance period. The total task amount with all change orders is $1,018,484.70. Funding is sourced from Budget Entity 37450300, Project GC897, with the following cost allocation: Org Code 37450401002, Fund 212001, Object Code 104138, Special Category 131545, and EO designation JN. The 31 additional sites are identified by FAC ID and facility name, primarily consisting of gas stations, convenience stores, and automotive service facilities located throughout Pinellas County.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| CN-370000-GC897-A2R1.pdf | ||
| CN-370000-GC897-T1CO1.pdf | ||
| CN-370000-GC897-T2.pdf | ||
| CN-370000-GC897-T9.pdf | ||
| CN-370000-GC897-T3.pdf | ||
| CN-370000-GC897-T5CO1.pdf | ||
| CN-370000-GC897-T5CO2.pdf | ||
| CN-370000-GC897-T6.pdf | ||
| CN-370000-GC897.pdf | ||
| CN-370000-GC897-A1.pdf | ||
| CN-370000-GC897-CO1.pdf | ||
| CN-370000-GC897-T1.pdf | ||
| CN-370000-GC897-T5.pdf | ||
| CN-370000-GC897-T8.pdf | ||
| CN-370000-GC897-CMC2.pdf | ||
| CN-370000-GC897-T10.pdf | ||
| CN-370000-GC897-T4.pdf | ||
| CN-370000-GC897-T7.pdf |
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Text version
OOO-012 (Effective 10-13-2017) Page 1 of 4
Florida Department of Environmental Protection
TASK ASSIGNMENT CHANGE ORDER FORM
Required Signatures: Adobe Signature
Task Assignment Number: __________________ Date: _______________ Change Order No.______________
Contractor Name: _________________________________________________________________
Contractor Representative: __________________________________________________________
DEP Contract Manager: _________ ___________
Description of Change (Use additional sheets if necessary):
Change in Task Amount
Item Cost Reimbursement Fee Schedule Total Original Task Amount:
Task amount prior to this change order:
Net increase/decrease in task amount:
Task amount with all change orders:
Change in Task Time
Original task completion date:
Completion date prior to this change:
Net increase/decrease in task period:
Completion date with all change orders:
GC897-4 03/09/2020 01
Florida Department of Health Pinellas County
Charles Minor
David G. Warfel
See Attached.
$932,834.70 $932,834.70
$932,834.70 $932,834.70
$85,650.00 $85,650.00 $1,030,484.70 $1,018,484.70
06/30/2020 06/30/2020 06/30/2020
OOO-012 (Effective 10-13-2017) Page 2 of 4
Florida Department of Environmental Protection
TASK ASSIGNMENT CHANGE ORDER FORM
Change in Funding Information
Budget Entity Project # Grant # Org Code Fund Special Category
Object Code
EO Amount
Total:
CONTRACTOR FLORIDA DEPARTMENT OF
ENVIRONMENTAL PROTECTION
Contract Manager Date Contract Manager Date
APPROVED:
Budget Representative Date
Deputy Secretary Date
Secretary Date cc: Procurement Section (MS93) Bureau of Finance & Accounting (MS78) - 2 copies
37450300 GC897 37450401002 212001 104138 131545 JN $85,650.00
$85,650.00
Digitally signed by Charles Minor DN: CN=Charles Minor, O=Environmental Health, OU=FL Department of Health - Pinellas, E=Charles.Minor@flhealth.gov, C=US Reason: I am the author of this document Location:
Date: 2020-03-25 15:30:24
Charles Minor
David G. Warfel Digitally signed by David G. Warfel Date: 2020.03.26 07:30:23 -04'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2020.03.26 11:09:59 -04'00'
John Truitt Digitally signed by John Truitt Date: 2020.03.26 13:45:56 -04'00'
Justin Wolfe Digitally signed by Justin Wolfe Date: 2020.04.10 14:03:12 -04'00'
Pursuant to existing contract between Florida Department of Health Pinellas County and State of Florida Department of Environmental Protection, GC897, Paragraph 3,B No Work may be performed under this Contract, until a Task Assignment Notification Form or Task Assignment Change Order Form has been fully executed by both Department and Local Program.
This Task Assignment Change Order is to authorize work to be performed on an additional 31 sites within Pinellas County as per the agreed upon and fully executed GC897 Task Assignment 4 in existence between Florida Department of Health Pinellas County and State of Florida Department of Environmental Protection. Payment for the additional sites will be issued for the invoice in the month the first assessment PO is issued this fiscal year.
The Department has determined through projection analysis that the total funds budgeted for Incentive Payments is in excess and can be reduced by $12,000.00.
Authorize additional funding for level of effort 31 sites X $3,150 site = $97,650 Reduction in funding for Incentive Payments $12,000 Net change in funding $85,650
Additional Assigned Sites due to Score Drop
FAC ID Name
9501770 HOMOSASSA RIVERSIDE RESORT
8519745 MIKES SUPER GAS INC
8515329 MCBRIDES MINI MART
8515438 MOBIL ST PETE BCH - FKA SUNCOAST #17
8520551 PINELLAS PARK CITY
8623471 TEXACO #807
8623560 AMOCO-B&F
8515121 AMS CITGO-PINELLAS 3100 TRUST
8623806 TEXACO-MILES
8515426 MOBIL IV
8515509 BP-EAST BAY
8515598 SNACK SHACK FOOD MART
8944596 MASTRY ENGINE CENTER
8623334 BOLLINGERS AUTO SERVICE
8515534 GLENDALE FEDERAL SAVING & LOAN
8623674 7-ELEVEN FOOD STORE #1552-23557
8628551 7-ELEVEN FOOD STORE #26347
8734706 RAY'S GARAGE
8735395 P D Q CARWASH
8842136 BP #37532
9800248 ECHELON DEVELOPMENT CORP PROPERTY
8623611 CIRCLE K #2211037
8520536 49TH ST N CITGO CORP
8626278 CITGO-CUMBERLAND #760
8623863 UNION 76-SOUTHSIDE
8515400 GULF BEACH PARTNERS LLC
9101289 O'HANRAHAN CONSULTANTS INC
8623463 WESTERN PROPERTIES
9201802 BAYFRONT ENTERPRISES PROPERTY
9047023 TEXACO #24-203-1361
8516830 BP STATION
| Pinellas-CO1.pdf |
| Pinellas TA CO PDF Description |
| PInellas additional sites for CO |
| Sheet1 |
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