CN-370000-GC915-T2CO1.pdf
PDF 1 MB Posted
- Contract number
- GC915
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Form OOO-012) issued by the Florida Department of Environmental Protection (FDEP) on July 25, 2018. The document pertains to Task Assignment Number GC915-2 with Hillsborough County as the contractor. Hooshang Boostani serves as the contractor representative, and Roger Ruiz is designated as the DEP Contract Manager. The change order was approved by Fletcher Herrald, Jennifer Vickers, and Tim J. Bahr on behalf of FDEP, with all parties executing the document via Adobe Signature.
The change order reflects an update to Attachment B - Scope of Work - Level 2, with an original task amount of $481,545.00. No net increase or decrease in the task amount is indicated, and the completion date remains June 30, 2019. The funding is allocated from Organizational Code 37450104000 under E.O. JD, with Object Code 132500, Budget Entity 37450300, and Special Category 100029. The total amount of $481,545.00 is funded through year 00, with copies distributed to the Procurement Section (MS93) and the Bureau of Finance & Accounting (MS78).
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Other files
| File | Type | Posted |
|---|---|---|
| CN-370000-GC915-ARC1.pdf.crdownload | CRDOWNLOAD file | |
| CN-370000-GC915-T1CO1.pdf | ||
| CN-370000-GC915-T4.pdf | ||
| CN-370000-GC915-T8CO1.pdf | ||
| CN-370000-GC915-T9.pdf | ||
| CN-370000-GC915.pdf.crdownload | CRDOWNLOAD file | |
| CN-370000-GC915-A2.pdf | ||
| CN-370000-GC915-T1CO2.pdf | ||
| CN-370000-GC915-T2.pdf | ||
| CN-370000-GC915-T7.pdf | ||
| CN-370000-GC915-ARC1.pdf | ||
| CN-370000-GC915-T2CO2.pdf | ||
| CN-370000-GC915-T2CO3.pdf | ||
| CN-370000-GC915-T3.pdf | ||
| CN-370000-GC915-T7CO1.pdf | ||
| CN-370000-GC915-T8.pdf | ||
| CN-370000-GC915-T1.pdf | ||
| CN-370000-GC915-T3CO1.pdf | ||
| CN-370000-GC915-T5.pdf | ||
| CN-370000-GC915-T6.pdf |
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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:
GC915-2 07/25/2018 1
HILLSBOROUGH COUNTY
Hooshang Boostani
Roger Ruiz
Updated Attachment B - Scope of Work - Level 2
481,545.00
06/30/19 06/30/19
06/30/19
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 $ 481,545.00
Hooshang Boostani
Digitally signed by Hooshang Boostani DN: cn=Hooshang Boostani, o=EPC, ou, email=boostani@epchc.org, c=US Date: 2018.07.26 07:51:42 -04'00'
07/26/2018 Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2018.08.17 14:01:50 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.08.17 14:42:46 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.08.17 14:51:31 -04'00'
File details come from the government source that posted it. Updated .