CN-370000-GC918-T13CO2.pdf
PDF 302 KB Posted
- Contract number
- GC918
- Issued by
- Florida
About this file
This document is a Task Assignment Change Order Form (Form OOO-012) issued by the Florida Department of Environmental Protection on April 22, 2024. The change order involves Alachua County as the contractor, with Ted Goodman serving as the contractor representative and Roger Ruiz as the DEP Contract Manager. The change order is identified as Change Order No. 2 under Task Assignment Number GC918-13.
The change order increases funding for Variable Inspections by $7,600, resulting in a net increase to the task amount from $382,137.77 to $389,737.77. The task completion date remains June 30, 2024, with no extension to the timeline. The funding is allocated across three line items under Organizational Code 37450104000, all using the same budget entity (37450300), special category (100029), and object code (132500). The three amounts distributed are $372,548.77, $9,589.00, and $7,600.00. The change order has been approved by Tameshia N. Reid (Budget Representative) and Teresa Booeshaghi (Contractual Authority), with copies directed to the Procurement Section (MS93) and the Bureau of Finance & Accounting (MS78).
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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:
GC918-13 04/22/2024 2
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Increase in funds for Variable Inspections for $7,600.
A net increase of $7,600.
372,548.77 372,548.77
382,137.77 382,137.77
+7,600 +7,600
389,737.77 389,737.77
06/30/24 06/30/24 +7,600 06/30/24
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 $ 372,548.77
37450104000 JD 132500 37450300 100029 00 $ 9,589.00
37450104000 JD 132500 37450300 100029 00 $ 7,600.00
Ted A. Goodman, P.G.
Digitally signed by Ted A.
Goodman, P.G.
Date: 2024.04.22 08:36:39 -04'00'
04/22/2024 Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.04.22 08:56:41 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.04.22 09:11:58 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.04.22 09:32:17 -04'00'
File details come from the government source that posted it. Updated .