CN-370000-GC912-T6CO2.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 May 31, 2023. The document modifies an existing task assignment (GC912-6) with the contractor Duval County, represented by Jean Richards. The change order was approved by DEP Contract Manager Roger Ruiz and processed through the Department's Budget Representative and Contractual Authority.
The change order reduces the scope of routine compliance inspections from 570 to 566 inspections, resulting in a net decrease of $2,180 to the task amount. The original task amount of $442,095 is reduced to $439,915 with this change order. The modification was requested by GC912-16 Duval County and does not alter the task completion date of June 30, 2023. Funding is allocated from budget entity 37450300 (Special Category 100029) under the Department's general operations account code 37450104000, with the reduction reflected as a negative adjustment of $2,180.
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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 05/31/2023 2
DUVAL COUNTY
Jean Richards
Roger Ruiz
Reduction of 4 Routine Compliance Inspections, from 570 to 566 Routine Compliance Inspections per request from GC912-16 Duval County.
A net decrease of $2,180.
442,095 442,095
442,095 442,095
-2,180 -2,180
439,915 439,915
06/30/23 06/30/23 -2,180 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 $ 442,095.00
37450104000 JD 132500 37450300 100029 00 -$ 2,180.00
Jean E. Richards Digitally signed by Jean E.
Richards Date: 2023.05.31 09:55:51 -04'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2023.05.31 10:10:13 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2023.05.31 13:11:24 -04'00'
Justin Wolfe Digitally signed by Justin Wolfe Date: 2023.06.01 09:01:09 -04'00'
File details come from the government source that posted it. Updated .