CN-370000-GC913-T1CO2.pdf

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Attached to
Master Agreement FL|GC913|1903a62f2685da1206aab1c3d3236eae
Contract number
GC913
Issued by
Florida

About this file

This is a Task Assignment Change Order Form (Change Order No. 2) issued by the Florida Department of Environmental Protection on April 20, 2018. The document involves Palm Beach County as the contractor, with Deborah Drum serving as the Contractor Representative and Roger Ruiz as the DEP Contract Manager. The change order pertains to Task Assignment Number GC913-1.

The change order reduces funding for Variable Inspections by a net decrease of $13,000.00. The original task amount was $520,511.02, which increased to $525,712.06 prior to this change order. With the $13,000.00 reduction applied, the task amount with all change orders is now $512,712.06. The task completion date remains June 30, 2018, with no change to the timeline. The funding is allocated under Organization Code 37450104000, with Budget Entity 37450300 and Special Category 100029 for fiscal year 2018. The revised contract amount of $512,712.06 is distributed across Cost Reimbursement and Fee Schedule components and has been approved by the 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:

GC913-1 04/20/2018 2

PALM BEACH COUNTY

Deborah Drum

Roger Ruiz

Reduction on funding for Variable Inspections.

A net decrease of $13,000.00

520,511.02 520,511.02

525,712.06 525,712.06

(13,000.00) (13,000.00)

512,712.06 512,712.06

06/30/18 06/30/18 (13,000.00) 06/30/18

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 2018 $ 512,712.06

Deborah L. Drum Digitally signed by Deborah L. Drum DN: cn=Deborah L. Drum, o=Palm Beach County Department of Environmental Resources Management, ou, email=ddrum@pbcgov.org, c=US Date: 2018.04.30 14:30:13 -04'00'

04/30/2018 Roger Ruiz Digitally signed by Roger Ruiz Date: 2018.04.30 16:55:16 -04'00'

Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.05.02 15:52:33 -04'00'

Digitally signed by F. Joseph Jr.

Ullo Date: 2018.05.09 07:48:45 -04'00'

File details come from the government source that posted it. Updated .