CN-370000-GC918-T10CO2.pdf
PDF 655 KB 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 June 6, 2022. The document involves the contractor Alachua County, with Ted Goodman representing the contractor and Roger Ruiz serving as the DEP Contract Manager. The change order is identified as Change Order No. 2 to Task Assignment GC918-10.
The change order reduces the scope of routine compliance inspections from 189 to 187 inspections, resulting in a net decrease of $1,031.00 to the task amount. The original task amount was $122,422.00; prior to this change order it was $121,906.50; and with all change orders applied, the final task amount is $120,875.50. The task completion date remains unchanged at June 30, 2022. Funding is allocated from Org. Code 37450104000 using Object Code 132500 under Budget Entity 37450300, Special Category 100029, for a total amount of $120,875.50. The change order was approved by Tameshia N. Reid (Budget Representative) and Teresa Booeshaghi (Contractual Authority) on June 7, 2022.
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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 06/06/2022 2
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Reduction of 2 Routine Compliance Inspections, from 189 to 187 Routine Compliance Inspections per request from GC918-10 Alachua County.
A net decrease of $1031.00.
122,422 122,422
121,906.50 121,906.50
-1,031 -1,031
120,875.50 120,875.50
06/30/22 06/30/22 -1,031 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 $ 120,875.50
Ted A. Goodman, P.G.
Digitally signed by Ted A.
Goodman, P.G.
Date: 2022.06.06 09:33:58 -04'00'
06/06/2022 Roger Ruiz Digitally signed by Roger Ruiz Date: 2022.06.06 10:37:35 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.06.07 14:54:22 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2022.06.07 15:01:10 -04'00'
File details come from the government source that posted it. Updated .