CN-370000-GC917-T15CO1.pdf
PDF 157 KB Posted
- Contract number
- GC917
- 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 (FDEP) dated November 12, 2024. The change order pertains to Task Assignment GC917-15 for Okeechobee County. The contractor is represented by Daniel Buchin, with Roger Ruiz serving as the DEP Contract Manager. The document has been approved by Tameshia N. Reid (Budget Representative) and Teresa Booeshaghi (Contractual Authority).
The change order modifies performance measures for the task due to personnel issues. Specifically, the contractor shall complete 32 percent (34 Routine Compliance Inspections) within the first four months of performance. The task amount remains unchanged at $97,727.21, funded through Org. Code 37450104000 with Object Code 132500 and Special Category 100029. The original task completion date and completion date with all change orders both remain set for June 30, 2025, indicating no change in the task timeline. All required signatures have been executed digitally as of November 14, 2024.
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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:
GC917-15 11/12/2024 1
OKEECHOBEE COUNTY
Daniel Buchin
Roger Ruiz
Performance Measures:
Due to personnel issues, GC917-15 Okeechobee County, for the first Performance Measures, after (4) four months shall complete (32%) or 34 Routine Compliance Inspections.
97,727.21 97,727.21
06/30/25 06/30/25
06/30/25
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 $ 97,727.21
Digitally signed by Daniel Buchin DN: CN=Daniel Buchin, E=daniel.buchin@ flhealth.gov Reason: I am the author of this document Location:
Date: 2024.11.14 10:07:53-05'00' Foxit PDF Editor Version: 13.1.2
Daniel Buchin 11/14/2024 Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.11.14 10:19:47 -05'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.11.14 10:34:12 -05'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.11.14 11:21:28 -05'00'
File details come from the government source that posted it. Updated .