CN-370000-GC912-T5CO3.pdf
PDF 364 KB Posted
- Contract number
- GC912
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 3) issued by the Florida Department of Environmental Protection (FDEP) for Task Assignment GC912-5, dated June 6, 2022. The contractor is Jean Richards, with Roger Ruiz serving as the DEP Contract Manager. The change order was requested by Duval County and has been approved by budget and contractual authority representatives.
The change order reflects a reduction in routine compliance inspections from 570 to 557, representing a net decrease of 13 inspections and resulting in a cost reduction of $6,701.50. The original task amount of $424,860 is reduced to $418,158.50 with all change orders applied. The task completion date remains unchanged at June 30, 2022. Funding is allocated from Organizational Code 37450104000 (JD) under Object Code 132500, Budget Entity 37450300, with Special Category 100029, for a total of $418,158.50. The change order has been digitally signed by all required parties, including the contractor, contract manager, budget representative, and contractual authority.
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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:
GC912-5 06/06/2022 3
Jean Richards
Roger Ruiz
Reduction of 13 Routine Compliance Inspections, from 570 to 557 Routine Compliance Inspections per request from GC912-5 Duval County.
A net decrease of $6,701.50.
424,860 424,860
424,860 424,860
-6,701.50 -6,701.50
418,158.50 418,158.50
06/30/22 06/30/22 -6,701.50 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 $ 418,158.50
Jean E. Richards Digitally signed by Jean E.
Richards Date: 2022.06.10 11:04:39 -04'00'
06/10/2022 Roger Ruiz Digitally signed by Roger Ruiz Date: 2022.06.13 09:39:23 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.06.13 10:35:58 -04'00'
John Truitt Digitally signed by John Truitt Date: 2022.06.13 10:58:55 -04'00'
File details come from the government source that posted it. Updated .