CN-370000-GC916-T13CO1.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 on March 6, 2024. The change order modifies an existing task assignment (GC916-13) with Brevard County, represented by Contractor Representative Tina Swanson. The DEP Contract Manager is Roger Ruiz, and the change order was approved by Budget Representative Tameshia N. Reid and Contractual Authority Teresa Booeshaghi.
The change order reduces funding for Variable Inspections by $6,000, resulting in a net decrease of $6,000 to the task amount. The original task amount of $216,566.96 is reduced to $210,566.96 following this change order. The task completion date remains unchanged at June 30, 2024. The funding adjustment is reflected in the budget coding as organization code 37450104000, with object code 132500 and budget entity code 37450300, special category 100029, resulting in a $6,000 reduction to the fiscal year allocation.
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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:
GC916-13 03/06/2024 1
BREVARD COUNTY
Tina Swanson
Roger Ruiz
Decrease in funds for Variable Inspections for $6,000.
A net decrease of $6,000.
216,566.96 216,566.96
216,566.96 216,566.96
-6,000 -6,000
210,566.96 210,566.96
06/30/24 06/30/24 -6,000 06/30/24
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 $ 216,566.96
37450104000 JD 132500 37450300 100029 00 -$ 6,000.00
Digitally signed by Tina C.
Swanson Date: 2024.03.06 09:58:43 -05'00'
03/06/2024 Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.03.06 12:29:15 -05'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.03.07 08:18:59 -05'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.03.07 08:23:44 -05'00'
File details come from the government source that posted it. Updated .