CN-370000-GC916-T9CO1.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 dated October 18, 2021. The document amends an existing contract with Brevard County, represented by contractor Douglas Divers, with DEP Contract Manager Roger Ruiz overseeing the agreement.
The change order addresses performance measures for task assignment GC916-9, establishing modified compliance expectations due to personnel changes. Specifically, for the first performance measures period after four months, Brevard County shall complete 26 percent, or 70 Routine Compliance Inspections. The task amount remains unchanged at $186,727.00 with no net increase or decrease. The original task completion date of June 30, 2022, remains in effect with all change orders. Funding is allocated from Org. Code 37450104000 under Object Code 132500, with the amount of $186,727.00 allocated in Special Category 100029. The document was approved by budget representative Tameshia N. Reid and contractual authority Teresa Booeshaghi on October 19, 2021.
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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:
GC916-9 10/18/2021 1
BREVARD COUNTY
Douglas Divers
Roger Ruiz
Performance Measures:
Due to personnel changes GC916-9 Brevard County, for the first Performance Measures after (4) four months shall complete (26%) or 70 Routine Compliance Inspections.
186,727 186,727
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 $ 186,727.00
Divers, Doug Digitally signed by Divers, Doug Date: 2021.10.18 16:09:47 -04'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2021.10.19 07:27:15 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2021.10.19 10:35:12 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2021.10.19 11:04:27 -04'00'
File details come from the government source that posted it. Updated .