CN-370000-GC914-T9CO2.pdf

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Attached to
Master Agreement FL|HW682|8fccc28dda898687f0dd3c309f3a996b
Contract number
HW682
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 Task Assignment GC914-9 with Leon County, effective April 29, 2026. The change order was prepared by contractor representative Edwin French and reviewed by FDEP Contract Manager Roger Ruiz. The document was approved by Tameshia N. Reid (Budget Representative) and Natasha Lampkin (Contractual Authority) on May 27, 2026.

The change order modifies the completion deadline for routine compliance inspections of storage tank systems at 215 facilities located in Leon, Gadsden, Jefferson, and Wakulla Counties, extending the deadline from May 31, 2026, to June 30, 2026. The task amount remains unchanged at $206,690.50, with no net increase or decrease in the contract value. Funding is allocated from Org. Code 37450100000 under Object Code 132500 with Special Category 100029 in the amount of $206,690.50. No change to the task cost structure occurred; only the completion timeline was extended by one month.

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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:

GC914-9 04/29/2026 2

LEON COUNTY

Edwin French

Roger Ruiz

This change revises the sentence in Task Assignment #9 for DEP Contract GC914 reading:

"Conduct routine compliance inspections for storage tank systems at the 215 facilities within Leon, Gadsden, Jefferson, and Wakulla Counties, identified in Exhibit #1, by May 31, 2026.", to read:

"Conduct routine compliance inspections for storage tank systems at the 215 facilities within Leon, Gadsden, Jefferson, and Wakulla Counties, identified in Exhibit #1, by June 30, 2026."

189,190.50 189,190.50

206,690.50 206,690.50

206,690.50 206,690.50

06/30/26 06/30/26

06/30/26

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

37450100000 JD 132500 37450300 100029 00 $ 206,690.50

Edwin C. French

IV

Digitally signed by Edwin C.

French IV Date: 2026.05.01 13:43:07 -04'00'

05/01/2026 Roger Ruiz Digitally signed by Roger Ruiz Date: 2026.05.04 08:21:38 -04'00'

Tameshia N. Reid Digitally signed by Tameshia N.

Reid Date: 2026.05.27 10:08:40 -04'00'

Natasha Lampkin Digitally signed by Natasha Lampkin Date: 2026.05.27 13:13:42 -04'00'

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