CN-370000-GC912-T6CO1.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 on August 30, 2022. The document concerns Task Assignment GC912-6 with Duval County as the contractor. Jean Richards serves as the contractor representative, and Roger Ruiz is the DEP Contract Manager. The change order has been approved by Tameshia N. Reid (Budget Representative) and John Truitt (Contractual Authority).
The change order increases funding for Ethanol/Biodiesel Inspections by $420. The original task amount of $441,675 is increased by $420, resulting in a revised task amount of $442,095. The task completion date remains June 30, 2023, with no extension to the timeline. Funding is allocated across two budget lines: $441,675.00 under Org. Code 37450104000, E.O. JD, Special Category 100029, Year 00; and $420.00 under Org. Code 37450104000, E.O. JG, Special Category 087889, Year 23. Both allocations utilize Object Code 132500 and Budget Entity 37450300. The change order has been distributed to the Procurement Section (MS93) and the Bureau of Finance & Accounting (MS78) for processing.
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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:
GC912-6 08/30/2022 1
DUVAL COUNTY
Jean Richards
Roger Ruiz
Increase in funds for Ethanol/Biodiesel Inspections for $420.
A net increase of $420.
441,675 441,675
441,675 441,675
+420 +420
442,095 442,095
06/30/23 06/30/23 +420 06/30/23
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 $ 441,675.00
37450104000 JG 132500 37450300 087889 23 $ 420.00
Jean E. Richards Digitally signed by Jean E.
Richards Date: 2022.08.30 15:21:36 -04'00'
08/30/2022 Roger Ruiz Digitally signed by Roger Ruiz Date: 2022.08.30 15:31:23 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.08.30 15:48:33 -04'00'
John Truitt Digitally signed by John Truitt Date: 2022.08.31 15:21:36 -04'00'
08/31/2022
File details come from the government source that posted it. Updated .