CN-370000-GC916-T14CO1.pdf
PDF 134 KB 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 document modifies an existing task assignment (GC916-14) with Brevard County as the contractor. Tina Swanson serves as the Contractor Representative, and Roger Ruiz is the DEP Contract Manager. The change order was approved by Tameshia N. Reid (Budget Representative) and Teresa Booeshaghi (Contractual Authority) on March 7, 2024.
The change order increases funds for Variable Inspections by $6,000, resulting in a net increase of $6,000 to the task assignment. The original task amount was $56,483.98, which remains unchanged prior to this modification. Following this change order, the total task amount is $62,483.98. The task completion date remains June 30, 2024, with no extension to the original timeline. Funding for this increase is allocated from Org. Code 37450104000 using Object Code 132500, Budget Entity 37450300, and Special Category 100029, with year code 00. Distribution of the documentation includes the Procurement Section (MS93) and the Bureau of Finance & Accounting (MS78).
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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:
GC916-14 03/06/2024 1
BREVARD COUNTY
Tina Swanson
Roger Ruiz
Increase in funds for Variable Inspections for $6,000.
A net increase of $6,000.
56,483.98 56,483.98
56,483.98 56,483.98
+6,000 +6,000
62,483.98 62,483.98
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 $ 56,483.98
37450104000 JD 132500 37450300 100029 00 $ 6,000.00
Digitally signed by Tina C.
Swanson Date: 2024.03.06 09:59:26 -05'00'
03/06/2024 Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.03.06 12:31:06 -05'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.03.07 08:19:52 -05'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.03.07 08:25:36 -05'00'
File details come from the government source that posted it. Updated .