CN-370000-GC898-T4CO1.pdf
PDF 1 MB Posted
- Contract number
- GC898
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection on March 5, 2020. The document involves the Florida Department of Health Polk County as the contractor and the State of Florida Department of Environmental Protection as the procuring agency. The change order is identified as Change Order No. 01 for Task Assignment GC898-4.
The change order reduces the total Incentive Payment budget under Task Assignment 4 by $30,000.00, reflecting a determination through projection analysis that budgeted funds for Incentive Payments exceeded actual needs. The original task amount of $626,617.00 is reduced to $596,617.00 with all change orders applied. The task completion date remains unchanged at June 30, 2020. The funding adjustment affects Budget Entity 37450300, Project GC898, with the reduction applied to Object Code 104138 under Fund 212001. The change order was approved by multiple signatories including the Budget Representative, Deputy Secretary, and Secretary, with all signatures executed between March 10 and April 10, 2020.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| CN-370000-GC898-T1.pdf | ||
| CN-370000-GC898-T4.pdf | ||
| CN-370000-GC898-T5CO2.pdf | ||
| CN-370000-GC898-T8.pdf | ||
| CN-370000-GC898-T10.pdf | ||
| CN-370000-GC898-T2.pdf | ||
| CN-370000-GC898-T3.pdf | ||
| CN-370000-GC898-T5.pdf | ||
| CN-370000-GC898-T6.pdf | ||
| CN-370000-GC898-CMC2.pdf | ||
| CN-370000-GC898-T5CO1.pdf | ||
| CN-370000-GC898-T7.pdf | ||
| CN-370000-GC898-T9.pdf | ||
| CN-370000-GC898.pdf | ||
| CN-370000-GC898-A1.pdf | ||
| CN-370000-GC898-A2R1.pdf | ||
| CN-370000-GC898-CMC.pdf |
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Text version
OOO-012 (Effective 10-13-2017) Page 1 of 2
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:
GC898-4 03/05/2020 01
Florida Department of Health Polk County
Ralph Meder
David G. Warfel
This Task Assignment Change Order is to reduce the Incentive Payment total amount budgeted under Task Assignment 4 between Florida Department of Health Polk County and State of Florida Department of Environmental Protection. The Department has determined through projection analysis that the total funds budgeted for Incentive Payments is in excess and can be reduced by $30,000.00.
$ 626,617.00 $ 626,617.00
$ 626,617.00 $ 626,617.00
-$30,000.00 -$30,000.00 $596,617.00 $596,617.00
06/30/2020 06/30/2020 06/30/2020
OOO-012 (Effective 10-13-2017) Page 2 of 2
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 GC898 37450401002 212001 104138 131545 JN -$30,000
-$30,000
Ralph J.
Meder, PG
Digitally signed by Ralph J.
Meder, PG Date: 2020.03.10 09:51:08 -04'00'
David G. Warfel Digitally signed by David G. Warfel Date: 2020.03.13 08:31:51 -04'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2020.03.19 15:08:52 -04'00'
John Truitt Digitally signed by John Truitt Date: 2020.03.26 13:46:21 -04'00'
Justin Wolfe Digitally signed by Justin Wolfe Date: 2020.04.10 14:03:33 -04'00'
File details come from the government source that posted it. Updated .