CN-370000-GC912-T2CO2.pdf
PDF 655 KB Posted
- Contract number
- GC912
- Issued by
- Florida
About this file
This document is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) on March 13, 2019. The change order pertains to a task assignment with Duval County, represented by Jean Richards. The contract manager for FDEP is Roger Ruiz. The change order was approved by Budget Representative Jennifer Vickers and Contractual Authority Fletcher Herrald.
The change order increases the task assignment funding by $20,000.00 to cover an increase in variable inspections. The original task amount was $419,500.00, resulting in a new total task amount of $439,500.00. The task completion date remains June 30, 2019 with no extension to the schedule. The funding increase is allocated across two budget categories: $419,500.00 under Object Code 132500 with Special Category 100029, and $20,000.00 under Object Code 132500 with Special Category 104138. Both budget lines are charged to Org. Code 37450104000 and Budget Entity 37450300. The change order was distributed to the Procurement Section and the Bureau of Finance & Accounting upon execution.
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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:
GC912-2 03/13/2019 2
DUVAL COUNTY
Jean Richards
Roger Ruiz
Increase of Funds for Variable Inspections in the amount of $20,000.00
419,500.00 419,500.00
419,500.00 419,500.00
+20,000.00 +20,000.00
439,500.00 439,500.00
06/30/19 06/30/19 +20,000.00 06/30/19
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 $ 419,500.00
37450104000 JN 132500 37450300 104138 00 $ 20,000.00
$ 439,500.00
Jean E. Richards Digitally signed by Jean E.
Richards Date: 2019.03.13 15:05:47 -04'00'
03/13/2019 Roger Ruiz Digitally signed by Roger Ruiz Date: 2019.03.13 15:12:09 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2019.03.14 09:49:40 -04'00'
Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2019.03.14 09:53:19 -04'00'
File details come from the government source that posted it. Updated .