CN-370000-GC916-T1CO2.pdf
PDF 653 KB Posted
- Contract number
- GC916
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 2) issued by the Florida Department of Environmental Protection (FDEP) on October 26, 2017. The document modifies an existing task assignment (GC916-1) with contractor Brevard County, represented by Douglas Divers. The change order was reviewed and approved by DEP Contract Manager Roger Ruiz, Budget Representative Jennifer Vickers, and Contractual Authority Tim J. Bahr.
The change order adjusts performance measures for the Brevard County task assignment due to recent hurricane impacts. The original task amount of $171,622.00 was increased prior to this change order to $173,336.88, with no net increase or decrease applied through Change Order No. 2, resulting in a final task amount of $173,336.88. The task completion date remains June 30, 2018, with no modification to the timeline. The performance measure modification specifies that after four months, Brevard County shall complete thirty-one percent (31%) of Routine Compliance Inspections as the initial performance benchmark. Funding is allocated from Org. Code 37450104000, E.O. JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, for fiscal year 2018 in the amount of $173,336.88.
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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 10/26/2017 2
BREVARD COUNTY
Douglas Divers
Roger Ruiz
Performance Measures:
Due to the recent Hurricanes, after four (4) months, the first performance measures for GC916-1 Brevard County shall be to complete thirty one percent (31%) of Routine Compliance Inspections.
171,622.00 171,622.00
173,336.88 173,336.88
0 0
173,336.88 173,336.88
06/30/18 06/30/18 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 2018 $ 173,336.88
Douglas Divers Digitally signed by Douglas Divers Date: 2017.10.27 08:29:50 -04'00' 10/27/2017 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2017.10.30 08:09:20 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2017.10.30 09:56:01 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2017.10.30 12:25:50 -04'00'
File details come from the government source that posted it. Updated .