CN-370000-GC904-222A.pdf
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- Contract number
- GC904
- Issued by
- Florida
About this file
Task Assignment Notification Form Summary
This document is a Task Assignment Notification Form issued by the Florida Department of Environmental Protection (FDEP) under the Petroleum Restoration Program. The contract involves FDEP, Geosyntec Consultants (contractor), and the Coyote Navarre C&D Debris Disposal Facility located at 3201 Five Forks Road in Navarre, Santa Rosa County, Florida. Key personnel include FDEP/LP Project Manager Brittany Anding, FDEP Contract Manager Melissa Brock, and contractor manager Joe Applegate. The task assignment is designated as GC 904-222A under FDEP Contract Number GC904.
The contract covers source removal and tank removal activities at the facility as part of the cleanup sub-phase. The task assignment is structured as a Fixed Unit Rate and Cost Reimbursable arrangement with a total cost of $33,290.85, including a 10% retainage of $3,329.09. The total encumbrance is $33,290.85. Work must be completed by August 1, 2023, with deliverables and final due dates specified in the referenced Scope of Work document. The contract was authorized on March 23, 2023, and subsequently signed by the contract manager on March 8, 2023.
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Text version
FDEP Contract Number:
FDEP Facility Id #:
Score:
Site Name:
Site Address:
Contractor Name:
Contractor Address:
Contractor Manager:
FDEP/LP Project Manager:
FDEP Contract Manager:
Cleanup Phase:
Cleanup Sub phase:
Task Assignments
Petroleum Restoration Program
GC904
ERIC13332
J::!.A
TASK ASSIGNMENT NOilFICA IlON FORM
Task Assignment#: GC 904-222A Category: !04132 Object Code: J31545.
Coyote Navarre C&D Debris Disposal Facility
3201 Five Forks Roac;l Geosvntec C onsultants
City:. Navarre
2039 Centre Point Blvd. STE 103, Talla,hassee FL 32308
Joe Applegate
BRITTANY ANDING
MELISSA BROCK
SOURCE REMOVAL
TANK REMOVAL
Budget Entity: J:Z4504Q1��5 Module: 11D.
EO: JC,
Eligibility: SCR
County: Santa Rosa
CID#: 003600
FEID#: 59-2355134
Phone#: [ 850.-55(5-8419 Phone#: . 85�-8856 Phone#: 850-2'1,5-8922
Task Assignment description and deliverable information are specified in the Scope of Work (SOW). The following attachments and or documents are hereby added to the contract.
Final Deliverable: (See scope of work} Final Due Date: (See scope of work}
Period of Task Performance: Task Assignment Return Date To AugustOl,2023 No work can be performed after this date
Task Assignment Type: Fixed Unit Rate and Cost Reimbursable Total Cost (Incl. retainage):
Retainage (10%) Total Encumbrance:
$ 33,290.85 $3,329.09 $ 33,290.85
FDEP/LP Project Manager Signature and Date: ------"---_____________ l_ l l
2l _____ _
I , FDEP Contract Manager Signature and Date:
J/2l/2l
Nata Sh a Lam P k.l n Digitally signed by Natasha Lampkin
Date: 20231l3.2.3 09:26:38 ·04'00' Cost Center Administrator Signature and Date: _________________________ _
Procurement Gatekeeper Signature and Date:
not applicable
Contract Manager Signature and Date:
FDEP Use Only: Technical Review (optional): Signature and Date : _________________ _
Fiscal Review: Signature and Date:, _________________ _
TA Return Date: Signature and Date :. _________________ _ https://prodapps.dep.state.fl.us/stcm/task_assignmenUPwoTaPrintDetails/taskAssignmenUGC 1/1
File details come from the government source that posted it. Updated .