CN-370000-GC918-T10CO1.pdf
PDF 1 MB Posted
- Contract number
- GC918
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection on April 25, 2022. The document modifies an existing task assignment under contract GC918-10 with Alachua County. The contractor representative is Ted Goodman, and the DEP Contract Manager is Roger Ruiz.
The change order reduces the scope of routine compliance inspections from 190 to 189 inspections, resulting in a net decrease of $515.50 to the task amount. The original task amount of $122,422.00 is reduced to $121,906.50. The completion date remains June 30, 2022, with no change to the task timeline. Funding for this task is charged to Organizational Code 37450104000 under E.O. JD, Object Code 132500, Budget Entity 37450300, with Special Category 100029, totaling $121,906.50. The change order was approved and digitally signed by all required parties on April 28, 2022, including the contractor, DEP Contract Manager, Budget Representative Tameshia N. Reid, and Contractual Authority John Truitt.
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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:
GC918-10 04/25/2022 1
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Reduction of 1 Routine Compliance Inspections, from 190 to 189 Routine Compliance Inspections per request from GC918-10 Alachua County.
A net decrease of $515.50.
122,422 122,422
122,422 122,422
-515.50 -515.50
121,906.50 121,906.50
06/30/22 06/30/22 -515.50 06/30/22
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 $ 121,906.50
Ted A. Goodman, P.G.
Digitally signed by Ted A.
Goodman, P.G.
Date: 2022.04.28 10:23:55 -04'00'
04/28/2022 Roger Ruiz Digitally signed by Roger Ruiz Date: 2022.04.28 12:35:11 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.04.28 14:20:55 -04'00'
John Truitt Digitally signed by John Truitt Date: 2022.04.28 14:34:12 -04'00'
File details come from the government source that posted it. Updated .