CN-370000-GC912-T3CO1.pdf
PDF 1 MB Posted
- Contract number
- GC912
- 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 October 9, 2019. The document pertains to task assignment GC912-3 for Duval County, with Jean Richards serving as the Contractor Representative and Roger Ruiz as the DEP Contract Manager. The change order was approved by Griffin Kolchakian (Budget Representative) and Teresa Booeshaghi (Contractual Authority).
The change order addresses performance measures for the Duval County task assignment, stipulating that due to hurricane preparations and office closure, the first performance measures after four months shall require completion of 29 percent of Routine Compliance Inspections or 168 Routine Compliance Inspections, whichever is applicable. The original task amount is $421,990.00 with no net increase or decrease indicated in the change order. The task completion date remains 06/30/20 across all versions. Funding is sourced from Org. Code 37450104000 under Executive Order JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, and Year 00, with the full amount of $421,990.00 allocated accordingly.
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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:
GC912-3 10/09/2019 1
DUVAL COUNTY
Jean Richards
Roger Ruiz
Performance Measures:
Due to hurricane preparations and office closure, GC912-3 Duval County, after (4) four months, the first performance measures for GC912-3 Duval County shall be to complete (29%) of Routine Compliance Inspections or 168 Routine Compliance Inspections.
421,990.00
06/30/20 06/30/20
06/30/20
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 $ 421,990.00
Jean E. Richards Digitally signed by Jean E.
Richards Date: 2019.10.09 10:38:55 -04'00'
10/09/2019 Roger Ruiz Digitally signed by Roger Ruiz Date: 2019.10.09 12:21:06 -04'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2019.10.09 13:18:51 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2019.10.09 13:40:08 -04'00'
File details come from the government source that posted it. Updated .