CN-370000-GC916-CO2.pdf
PDF 1 MB Posted
- Contract number
- GC916
- 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 document modifies an existing task assignment (GC916-2) with contractor Brevard County, represented by Douglas Divers, under the supervision of FDEP Contract Manager Roger Ruiz. The change order was approved by Jennifer Vickers (Budget Representative) and Fletch Herrald (Contractual Authority) on August 7, 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 routine inspection, effective September 1, 2017. Inspections conducted through August 31, 2017, remain payable at the original rate of $510.40. The net increase in the task amount is $516.38, bringing the total task amount from $51,678.00 to $52,194.38. The task completion date remains June 30, 2018. Funding is allocated from Organization Code 37450104000, utilizing Object Code 132500, Budget Entity 37450300, and Special Category 100029, with the total approved amount of $52,194.38 charged to year 00.
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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:
GC916-2 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.
51,678.00 51,678.00
51,678.00 51,678.00
516.38 516.38
52,194.38 52,194.38
06/30/18 06/30/18 516.38 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 $ 52,194.38
Douglas Divers Digitally signed by Douglas Divers Date: 2017.08.07 08:36:44 -04'00' 08/07/2017 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2017.08.07 10:40:44 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2017.08.07 14:35:39 -04'00'
08/07/2017
Fletch Herrald Digitally signed by Fletch Herrald Date: 2017.08.14 13:19:44 -04'00'
File details come from the government source that posted it. Updated .