CN-370000-GC910-T2CO2.pdf
PDF 655 KB 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 November 14, 2018. The document pertains to Task Assignment Number 910-2 with Escambia County as the contractor, represented by Greg Berrian. Roger Ruiz serves as the DEP Contract Manager. The change order has been approved by Jennifer Vickers (Budget Representative) and Fletcher Herrald (Contractual Authority).
The change order increases funding for variable inspections by $40,000.00, bringing the total task amount from $417,510.00 to $457,510.00. The task completion date remains fixed at June 30, 2019, with no extension to the timeline. Funding is allocated under Organizational Code 37450104000, E.O. JD, Object Code 132500, Budget Entity 37450300, and Special Category 100029, with the full amount of $457,510.00 reflected in Year 00. The change order was executed with digital signatures from all parties between November 15 and November 19, 2018.
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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 11/14/2018 2
Escambia County
Greg Berrian
Roger Ruiz
Increase of Funds for Variable Inspections in the amount of $40,000.00.
417,510.00 417,510.00
417,510.00 417,510.00
+40,000.00 +40,000.00
457,510.00 457,510.00
06/30/19 06/30/19 +40,000.00 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 $ 457,510.00
Gregory Berrian Digitally signed by Gregory Berrian Date: 2018.11.15 10:08:38 -06'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2018.11.16 06:35:36 -05'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.11.16 13:46:41 -05'00'
Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2018.11.19 08:58:55 -05'00'
File details come from the government source that posted it. Updated .