CN-370000-GC910-T5CO1.pdf
PDF 1 MB Posted
- Contract number
- GC910
- Issued by
- Florida
About this file
Summary
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection on June 14, 2022. The change order modifies an existing task assignment (GC910-5) between the Florida Department of Environmental Protection and Escambia County. Gregory Berrian serves as the Contractor Representative, and Roger Ruiz is the DEP Contract Manager responsible for overseeing the modification.
The change order increases funding for Variable Inspections by $24,000, resulting in a net increase to the task amount from $369,869 to $393,869. The task completion date remains unchanged at June 30, 2022. Funding is allocated from Organizational Code 37450104000 under E.O. code JD, with Object Code 132500, Budget Entity 37450300, Special Category 100029, and Year 00, totaling $393,869.00. The change order was approved by Tameshia N. Reid (Budget Representative) and John Truitt (Contractual Authority) on June 15, 2022, with copies distributed to the Procurement Section and Bureau of Finance & Accounting.
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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:
GC910-5 06/14/2022 1
Escambia County
Gregory Berrian
Roger Ruiz
Increase in funds for Variable Inspections for $24,000.
A net increase of $24,000.
369,869 369,869
369,869 369,869
+24,000 +24,000
393,869 393,869
06/30/22 06/30/22 +24,000 06/30/22
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 $ 393,869.00
Gregory M Berrian Digitally signed by Gregory M Berrian Date: 2022.06.14 15:40:15 -05'00'
06/14/2022 Roger Ruiz Digitally signed by Roger Ruiz Date: 2022.06.15 07:21:15 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.06.15 10:51:52 -04'00'
John Truitt Digitally signed by John Truitt Date: 2022.06.15 12:18:11 -04'00'
File details come from the government source that posted it. Updated .