CN-370000-GC916-CO1.pdf
PDF 1 MB Posted
- Contract number
- GC916
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 1) issued by the Florida Department of Environmental Protection (FDEP) for a contract with Brevard County, represented by contractor Douglas Divers. The change order was dated August 2, 2017, with signatures executed on August 7, 2017. Contract Manager Roger Ruiz managed the change order on behalf of FDEP, and the document was approved by Jennifer Vickers (Budget Representative) and Tim J. Bahr (Contractual Authority).
The change order modifies the pricing for routine inspection services, increasing the per-inspection fee from $510.40 to $515.50, effective September 1, 2017. This represents a net increase of $5.10 per routine inspection. The modification added $1,714.88 to the original task amount of $171,622.00, resulting in a revised total task amount of $173,336.88. All inspections conducted through August 31, 2017, were to be paid at the original rate of $510.40. The task completion date remained unchanged at June 30, 2018. Funding was allocated from Organization Code 37450104000 under Budget Entity 37450300, Special Category 100029, with the full amount of $173,336.88 charged to this line item.
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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:
GC916-1 08/02/2017 1
BREVARD COUNTY
Douglas Divers
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.
171,622.00 171,622.00
171,622.00 171,622.00
1,714.88 1,714.88
173,336.88 173,336.88
06/30/18 06/30/18 1,714.88 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 $ 173,336.88
Douglas Divers Digitally signed by Douglas Divers Date: 2017.08.07 08:33:46 -04'00' 08/07/2017 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2017.08.07 10:42:27 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2017.08.07 14:30:31 -04'00'
08/07/2017
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2017.08.07 17:07:18 -04'00'
File details come from the government source that posted it. Updated .