CN-370000-GC911-T5CO1.pdf

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Attached to
Master Agreement FL|GC911|7fad29d6b3cd25f6cd90c1c00b9c09ae
Contract number
GC911
Issued by
Florida

About this file

This is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) dated June 9, 2022. The change order modifies an existing task assignment with DADE COUNTY, represented by contractor Bernardo Bieler, P.E. The DEP Contract Manager is Roger Ruiz. The change order was approved by Budget Representative Tameshia N. Reid and Contractual Authority John Truitt.

The change order increases funding for Variable Inspections by $21,000, raising the total task amount from $375,825 to $396,825. The task completion date remains June 30, 2022, with no extension to the contract period. The funding is allocated under Org. Code 37450104000 with E.O. designation JD, Object Code 132500, Budget Entity 37450300, and Special Category 100029. The total contract value following this change order is $396,825.00, with copies distributed to the Procurement Section (MS93) and Bureau of Finance & Accounting (MS78).

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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:

GC911-5 06/09/2022 1

DADE COUNTY

Bernardo Bieler, P.E.

Roger Ruiz

Increase in funds for Variable Inspections for $21,000.

A net increase of $21,000.

375,825 375,825

375,825 375,825

+21,000 +21,000

396,825 396,825

06/30/22 06/30/22 +21,000 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 $ 396,825.00

Digitally signed by Bernardo M.

Bieler Date: 2022.06.09 10:03:19 -04'00'

06/09/2022 Roger Ruiz Digitally signed by Roger Ruiz Date: 2022.06.09 11:01:34 -04'00'

Tameshia N. Reid Digitally signed by Tameshia N.

Reid Date: 2022.06.09 11:09:33 -04'00'

John Truitt Digitally signed by John Truitt Date: 2022.06.09 11:25:58 -04'00'

File details come from the government source that posted it. Updated .