CN-370000-GC917-T15CO3.pdf
PDF 655 KB Posted
- Contract number
- GC917
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 3) issued by the Florida Department of Environmental Protection for DEP Contract GC917-15. The contract involves Okeechobee County as the contractor, with Daniel Buchin serving as the contractor representative and Roger Ruiz as the DEP Contract Manager. The change order was dated June 4, 2025, and has been approved by the Budget Representative (Tameshia N. Reid) and Contractual Authority (Fletch Herrald).
The change order modifies Task Assignment #8 due to personnel issues, reducing the scope of routine compliance inspections for storage tank systems from 106 facilities to 48 facilities (45 percent completion) within Okeechobee and Highlands Counties. The original completion date of May 31, 2025, has been extended to June 30, 2025. The task amount remains $97,727.21, funded through Organizational Code 37450104000 with Object Code 132500, Special Category 100029, and charged to Budget Entity 37450300. No net increase or decrease in task amount is reflected in this change order, as the adjustment addresses scope and timeline modifications rather than cost adjustments.
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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 06/04/2025 3
OKEECHOBEE COUNTY
Daniel Buchin
Roger Ruiz
Performance Measures:
Due to personnel issues, for Invoice 12, GC917-15 Okeechobee County, shall complete (45%) or 48 Routine Compliance Inspections.
This change revises the sentence in Task Assignment #8 for DEP Contract GC917 reading:
"Conduct routine compliance inspections for storage tank systems at the 106 facilities within Okeechobee and Highlands Counties, identified in Exhibit #1, by May 31, 2025.", to read:
"Conduct routine compliance inspections for storage tank systems at the 48 facilities within Okeechobee and Highlands Counties, identified in Exhibit #1, by June 30, 2025."
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: 2025.06.04 19:22:04-04'00' Foxit PDF Editor Version: 13.1.7
Daniel Buchin 06/04/2025 Roger Ruiz Digitally signed by Roger Ruiz Date: 2025.06.05 08:00:30 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2025.06.05 08:56:49 -04'00'
Fletch Herrald Digitally signed by Fletch Herrald Date: 2025.06.05 09:10:51 -04'00'
File details come from the government source that posted it. Updated .