CN-370000-GC910-T8CO1.pdf
PDF 127 KB Posted
- Contract number
- GC910
- Issued by
- Florida
About this file
This document is a Task Assignment Change Order Form (Form OOO-012) issued by the Florida Department of Environmental Protection (FDEP) for a contract with Escambia County. The change order is dated April 22, 2025, and is identified as Change Order No. 1 for Task Assignment Number GC910-8. The contractor representative is Robert Jake Gallman, and the FDEP Contract Manager is Roger Ruiz.
The change order increases funding for Variable Inspections by $31,680, resulting in a net increase to the total task amount. The original task amount was $459,796.12, and with this change order, the revised total task amount is $491,476.12. The task completion date remains June 30, 2025, with no adjustment to the timeline. Funding is allocated from Org. Code 37450104000 under object code 132500, budget entity 37450300, special category 100029, with the amounts of $459,796.12 and $31,680.00 distributed across two line items. The change order was approved by Budget Representative Tameshia N. Reid on April 23, 2025, and by Contractual Authority John J Truitt on the same date.
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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:
GC910-8 04/22/2025 1
Escambia County
Robert Jake Gallman
Roger Ruiz
Increase in funds for Variable Inspections for $31,680.
A net increase of $31,680.
459,796.12 459,796.12
459,796.12 459,796.12
+31,680 +31.680
491,476.12 491,476.12
06/30/25 06/30/25 +31,680 06/30/25
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 $ 459,796.12
37450104000 JD 132500 37450300 100029 00 $ 31,680.00
Robert Jake Gallman
Digitally signed by Robert Jake Gallman Date: 2025.04.22 15:56:17 -05'00'
04/22/2025 Roger Ruiz Digitally signed by Roger Ruiz Date: 2025.04.23 08:17:55 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2025.04.23 09:51:44 -04'00'
John J Truitt Digitally signed by John J Truitt Date: 2025.04.23 12:15:02 -04'00'
04/23/2025
File details come from the government source that posted it. Updated .