CN-370000-GC915-T1CO1.pdf

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Master Agreement FL|GC915|cb5ecb1bc3c7ba4bc0fe3459697a71a2
Contract number
GC915
Issued by
Florida

About this file

This is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) on August 2, 2017. The change order modifies an existing contract with Hillsborough County, represented by Hooshang Boostani. The contract manager for FDEP is Roger Ruiz. The document was approved by Jennifer Vickers (Budget Representative) and John Truitt (Contractual Authority) on August 7-11, 2017.

The change order increases the per-unit cost for routine inspections from $510.40 to $515.50, representing a net increase of $5.10 per inspection, effective September 1, 2017. All inspections conducted through August 31, 2017, remain billable at the original rate of $510.40. The total task amount increases by $4,929.00 from the prior amount of $493,286.29 to $498,215.29. The task completion date remains June 30, 2018. Funding is allocated from Org. Code 37450104000 under Object Code 132500 (Budget Entity 37450300, Special Category 100029) in the amount of $498,215.29. The change order is designated as Change Order No. 1 for Task Assignment GC915-1.

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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:

GC915-1 08/02/2017 1

HILLSBOROUGH COUNTY

Hooshang Boostani

Roger Ruiz

Amount increase per Routine Inspection from $510.40 to $515.50.

A net increase of $5.10 per Routine Inspection.

The increase will become effective September 1, 2017. All inspections conducted through August 31, 2017, will be paid at the rate of $510.40.

493,286.29 493,286.29

493,286.29 493,286.29

4,929.00 4,929.00

498,215.29 498,215.29

06/30/18 06/30/18 4,929.00 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 00 $ 498,215.29

Hooshang Boostani

Digitally signed by Hooshang Boostani DN: cn=Hooshang Boostani, o=EPC, ou, email=boostani@epchc.org, c=US Date: 2017.08.04 15:27:41 -04'00'

08/04/2017 Roger Ruiz Digitally signed by Roger Ruiz Date: 2017.08.07 10:26:48 -04'00'

Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2017.08.07 14:29:59 -04'00'

08/07/2017

John Truitt Digitally signed by John Truitt Date: 2017.08.11 14:58:35 -04'00'

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