CN-370000-GC916-T10CO1.pdf
PDF 656 KB Posted
- Contract number
- GC916
- 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). The document pertains to Task Assignment Number GC916-10 and represents the first change order dated February 22, 2022. The contractor is Brevard County, represented by Douglas Divers, with Roger Ruiz serving as the DEP Contract Manager.
The change order addresses performance measure adjustments due to personnel changes affecting the Brevard County (Indian River) segment of the contract. Specifically, for the second performance measurement period after eight months, the contractor shall complete 55 percent of routine compliance inspections, equating to 44 inspections. The original task amount of $49,838 remains unchanged with no net increase or decrease in task amount. The task completion date remains June 30, 2022, with no extension to the task period. Funding is sourced from Organizational Code 37450104000, with Object Code 132500, Budget Entity 37450300, and Special Category 100029. The change order was approved by Budget Representative Tameshia N. Reid and Contractual Authority Teresa Booeshaghi on February 22, 2022, with copies distributed to the Procurement Section and Bureau of Finance & Accounting.
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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:
GC916-10 02/22/2022 1
BREVARD COUNTY
Douglas Divers
Roger Ruiz
Performance Measures:
Due to personnel changes GC916-10 Brevard (Indian River) County, for the second Performance Measures after (8) eight months shall complete (55 %) or 44 Routine Compliance Inspections.
49,838 49,838
06/30/22
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 $ 49,838.00
Divers, Doug Digitally signed by Divers, Doug Date: 2022.02.22 09:17:03 -05'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2022.02.22 09:59:55 -05'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.02.22 10:52:22 -05'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2022.02.22 11:31:32 -05'00'
File details come from the government source that posted it. Updated .