CN-370000-GC910-T2CO1.pdf
PDF 1 MB Posted
- Contract number
- GC910
- 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 July 18, 2018. The document pertains to Task Assignment Number 910-2 involving Escambia County as the contractor, with Greg Berrian serving as the contractor representative and Roger Ruiz as the DEP contract manager.
The change order documents an update to Attachment A - Scope of Work with an original task amount of $417,510.00 and a completion date of June 30, 2019. The funding is allocated from Organizational Code 37450104000 with an Object Code 132500, Budget Entity 37450300, and Special Category 100029. The full contract amount of $417,510.00 remains unchanged with no net increase or decrease in the task period. The document was approved by multiple Florida DEP representatives, including Fletcher Herrald (Contract Manager), Jennifer Vickers (Budget Representative), and Tim J. Bahr (Contractual Authority), all with digital signatures dated August 8, 2018. Distribution copies were directed to the Procurement Section (MS93) and Bureau of Finance & Accounting (MS78).
View the file
Other files
Show all 21
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
OOO-012 (Effective 09-14-2015) 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:
910-2 07/18/2018 1
Escambia County
Greg Berrian
Roger Ruiz
Updated Attachment A - Scope of Work
417,510.00
06/30/19 06/30/19
06/30/19
OOO-012 (Effective 09-14-2015) Page 2 of 2
Florida Department of Environmental Protection
TASK ASSIGNMENT CHANGE ORDER FORM
Change in Funding Information
Org. Code E.O. Object Code Budget Entity
Special Category
Grant # Year Amount
CONTRACTOR FLORIDA DEPARTMENT OF
ENVIRONMENTAL PROTECTION
Contract Manager Date Contract Manager Date
APPROVED:
Budget Representative Date
Contractual Authority Date cc: Procurement Section (MS93) Bureau of Finance & Accounting (MS78) - 2 copies
37450104000 JD 132500 37450300 100029 00 $ 417,510.00
Gregory Berrian Digitally signed by Gregory Berrian Date: 2018.08.08 08:40:56 -05'00' Fletcher Herrald Digitally signed by Fletcher Herrald
Date: 2018.08.08 10:45:11 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.08.08 11:52:55 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.08.08 13:55:14 -04'00'
File details come from the government source that posted it. Updated .