CN-370000-GC912-T3CO3.pdf
PDF 655 KB 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 (FDEP) for DEP Contract GC912. The document involves DUVAL COUNTY as the contractor, with Jean Richards serving as the contractor representative and Roger Ruiz as the FDEP contract manager. The change order was executed on May 18, 2020, and is designated as Change Order No. 3 for Task Assignment GC912-3.
The change order modifies the completion deadline for routine compliance inspections of storage tank systems at 580 facilities located within Duval, Nassau, Baker, and Saint John Counties. The original deadline of May 31, 2020, is extended to June 30, 2020. The task amount remains unchanged at $454,356.00, with no net increase or decrease in the contract value. The funding is sourced from Org. Code 37450104000 under Object Code 132500, Budget Entity 37450300, Special Category 100029, with the full amount of $454,356.00 allocated for the year 2000. The change order was approved by Budget Representative Monica J. Brady and Contractual Authority Tim J. Bahr.
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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 05/18/2020 3
DUVAL COUNTY
Jean Richards
Roger Ruiz
This change revises the sentence in Task Assignment #3 for DEP Contract GC912 reading:
"Conduct routine compliance inspections for storage tank systems at the 580 facilities within Duval, Nassau, Baker and Saint John Counties, identified in Exhibit #1, by May 31, 2020.", to read:
"Conduct routine compliance inspections for storage tank systems at the 580 facilities within Duval, Nassau, Baker and Saint John Counties, identified in Exhibit #1, by June 30, 2020."
421,990 421,990
454,356 454,356
0.00 0.00
454,356 454,356
06/30/20 06/30/20 0.00 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 $ 454,356.00
Jean E. Richards Digitally signed by Jean E.
Richards Date: 2020.05.18 09:05:07 -04'00'
05/18/2020 Roger Ruiz Digitally signed by Roger Ruiz Date: 2020.05.18 09:10:34 -04'00'
Monica J. Brady Digitally signed by Monica J.
Brady Date: 2020.05.18 17:39:42 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2020.05.19 07:54:56 -04'00'
File details come from the government source that posted it. Updated .