CN-370000-GC912-T1CO3.pdf
PDF 655 KB Posted
- Contract number
- GC912
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) on December 5, 2017. The document modifies an existing task assignment contract with Duval County, identified as task assignment number GC912-1. Jean Richards serves as the Contractor Representative for Duval County, while Roger Ruiz acts as the DEP Contract Manager. The change order has been approved by Jennifer Vickers (Budget Representative) and John J. Truitt (Contractual Authority).
The change order represents a funding increase of $35,000 for variable inspections under task assignment GC912-1 for Duval County. The original task amount was $375,960.64, which had previously been increased to $379,717.30. With this additional funding increase, the total task amount with all change orders is now $414,717.30. The task completion date remains June 30, 2018, with no extension to the original timeline. Funding is charged to organizational code 37450104000 under object code 132500 with special category code 100029, with the total amount of $414,717.30 allocated in year 00.
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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:
GC912-1 12/05/2017 3
DUVAL COUNTY
Jean Richards
Roger Ruiz
Funding Increase for Variable Inspections in the amount of $35,000 for GC912-1 Duval County.
375,960.64 375,960.64
379,717.30 379,717.30
35,000.00 35,000.00
414,717.30 414,717.30
06/30/18 06/30/18 38,756.66 06/30/18
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 $ 414,717.30
Jean E. Richards Digitally signed by Jean E.
Richards Date: 2017.12.06 10:48:35 -05'00'
12/06/2017 Roger Ruiz Digitally signed by Roger Ruiz Date: 2017.12.06 11:08:51 -05'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2017.12.06 11:24:41 -05'00'
12/06/2017
John J. Truitt Digitally signed by John J. Truitt Date: 2017.12.07 15:26:36 -05'00'
File details come from the government source that posted it. Updated .