CN-370000-GC917-T17CO1.pdf
PDF 158 KB Posted
- Contract number
- GC917
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Form OOO-012) issued by the Florida Department of Environmental Protection on November 3, 2025. The document pertains to Task Assignment GC917-17 with Okeechobee County, with Daniel Buchin serving as the contractor representative and Roger Ruiz as the DEP Contract Manager. The change order has been approved by Tameshia N. Reid (Budget Representative) and Fletch Herrald (Contractual Authority).
The change order addresses performance measures for the Okeechobee County task due to personnel issues. Specifically, the contractor is required to complete 2 Routine Compliance Inspections (2%) within the first four months of performance. The original task amount remains $92,008.14, with no net increase or decrease in the task amount. The task completion date is June 30, 2026, with no changes to the original timeline. Funding is allocated from Org. Code 37450100000 under E.O. JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, in the amount of $92,008.14.
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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:
GC917-17 11/03/2025 1
OKEECHOBEE COUNTY
Daniel Buchin
Roger Ruiz
Performance Measures:
Due to personnel issues, GC917-17 Okeechobee County, for the first Performance Measures, after (4) four months shall complete (2%) or 2 Routine Compliance Inspections.
92,008.14 92,008.14
06/30/26 06/30/26
06/30/26
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
37450100000 JD 132500 37450300 100029 00 $ 92,008.14
Digitally signed by Daniel Buchin DN: CN=Daniel Buchin, E=Daniel.Buchin@ flhealth.gov Reason: I am the author of this document Location:
Date: 2025.11.03 08:39:28-05'00' Foxit PDF Editor Version: 13.2.1
Daniel Buchin 11/03/2025 Roger Ruiz Digitally signed by Roger Ruiz Date: 2025.11.03 08:54:13 -05'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2025.11.03 11:34:28 -05'00'
Fletch Herrald Digitally signed by Fletch Herrald Date: 2025.11.19 16:38:34 -05'00'
File details come from the government source that posted it. Updated .