CN-370000-GC917-T16CO2.pdf

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Attached to
Master Agreement FL|GC917|07963924f771028d1313984d19570664
Contract number
GC917
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 dated February 10, 2025. The document involves OKEECHOBEE COUNTY as the contractor, with Daniel Buchin serving as the contractor representative and Roger Ruiz as the DEP Contract Manager. The task assignment number is GC917-16.

The change order addresses performance measures for the Okeechobee County contract due to personnel issues. Specifically, for the second performance measures period after eight months, the contractor shall complete 13 Routine Compliance Inspections, representing 21% of the required work. The task amount remains $54,076.29 with no increase or decrease in funding. The task completion date is maintained at June 30, 2025, with no extension to the original timeline. The funding is allocated from Organizational Code 37450104000, E.O. JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, in the amount of $54,076.29 for year 00. The change order has been approved by Budget Representative Tameshia N. Reid and Contractual Authority Teresa Booeshaghi as of February 11, 2025.

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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:

GC917-16 02/10/2025 2

OKEECHOBEE COUNTY

Daniel Buchin

Roger Ruiz

Performance Measures:

Due to personnel issues, GC917-16 Okeechobee County, for the second Performance Measures, after (8) eight months shall complete (21%) or 13 Routine Compliance Inspections.

54,076.29 54,076.29

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 $ 54,076.29

Digitally signed by Daniel Buchin DN: CN=Daniel Buchin, E=daniel.buchin@ flhealth.gov Reason: I am the author of this document Location:

Date: 2025.02.10 14:26:15-05'00' Foxit PDF Editor Version: 13.1.2

Daniel Buchin 02/10/2025 Roger Ruiz Digitally signed by Roger Ruiz Date: 2025.02.10 14:54:15 -05'00'

Tameshia N. Reid Digitally signed by Tameshia N.

Reid Date: 2025.02.10 15:31:52 -05'00'

Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2025.02.11 08:35:56 -05'00'

File details come from the government source that posted it. Updated .