CN-370000-GC917-T8CO2.pdf
PDF 673 KB Posted
- 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 (FDEP) on May 19, 2021, for work performed by Okeechobee County. The document was processed by FDEP Contract Manager Roger Ruiz and contractor representative Victor Faconti. The change order was approved by Budget Representative Monica J. Brady and Contractual Authority Teresa Booeshaghi on May 25 and May 26, 2021, respectively.
The change order provides a net increase of $90.00 in funding for Variable Inspections services under Task Assignment GC917-8. The original task amount was $45,356.00; with the increase of $90.00, the revised total task amount is $45,446.00. The task completion date remains June 30, 2021, with no extension to the task period. Funding is allocated from Organizational Code 37450104000 under Object Code 132500, Budget Entity 37450300, Special Category 100029, with the total amount of $45,446.00 charged to the designated budget line.
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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:
GC917-8 05/19/2021 2
OKEECHOBEE COUNTY
Victor Faconti
Roger Ruiz
Increase in funds for Variable Inspections for $90.00.
A net increase of $90.00.
45,356 45,356
+90.00 +90.00
45,446 45,446
45,446 45,446
06/30/21 06/30/21 +90.00 06/30/21
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 $ 45,446.00
05/25/2021 Roger Ruiz Digitally signed by Roger Ruiz Date: 2021.05.25 15:24:23 -04'00'
Monica J. Brady Digitally signed by Monica J.
Brady Date: 2021.05.25 16:08:31 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2021.05.26 10:18:09 -04'00'
File details come from the government source that posted it. Updated .