CN-370000-GC910-T7CO1.pdf
PDF 364 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 April 22, 2024, for Task Assignment GC910-7. The contractor is Escambia County, represented by Robert Jake Gallman, with Roger Ruiz serving as the DEP Contract Manager. The change order has been approved by Tameshia N. Reid (Budget Representative) and Teresa Booeshaghi (Contractual Authority).
The change order increases funding for Variable Inspections by $38,000, bringing the total task amount from $440,231.12 to $478,231.12. The task completion date remains June 30, 2024, with no modification to the timeline. The funding is allocated under Organization Code 37450104000, E.O. code JD, Object Code 132500, Budget Entity 37450300, and Special Category 100029 (Year 00). Two separate line items are documented: $393,869.00 as the original amount and $38,000.00 as the additional funding. Distribution copies have been directed to the Procurement Section (MS93) and the 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:
GC910-7 04/22/2024 1
Escambia County
Robert Jake Gallman
Roger Ruiz
Increase in funds for Variable Inspections for $38,000.
A net increase of $38,000.
440,231.12 440,231.12
440,231.12 440,231.12
+38,000 +38,000
478,231.12 478,231.12
06/30/24 06/30/24 +38,000 06/30/24
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
37450104000 JD 132500 37450300 100029 00 $ 38,000.00
Robert Jake Gallman
Digitally signed by Robert Jake Gallman Date: 2024.04.22 08:08:02 -05'00'
04/22/2024 Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.04.22 09:20:22 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.04.22 09:42:34 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.04.22 09:57:23 -04'00'
File details come from the government source that posted it. Updated .