CN-370000-GC918-T14CO1.pdf
PDF 655 KB Posted
- Contract number
- GC918
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 1) issued by the Florida Department of Environmental Protection (FDEP) dated March 25, 2024. The change order modifies Task Assignment Number GC918-14 with Alachua County as the contractor. Ted Goodman serves as the contractor representative, and Roger Ruiz is the FDEP contract manager. The document was approved by Budget Representative Fletch Herrald and Contractual Authority Teresa Booeshaghi on March 26, 2024.
The change order decreases the task amount by $9,589 for Variable Inspections, reducing the total task amount from $134,299.11 to $124,710.11. The task completion date remains unchanged at June 30, 2024. The funding adjustment is reflected in the budget entity code 37450300 under Special Category 100029, with the decreased amount of $9,589.00 being removed from the original allocation. The change order maintains the same organizational code (37450104000), expenditure category (JD), and object code (132500) as the original task assignment. Copies of the approved change order are to be distributed to the Procurement Section (MS93) and two copies to 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:
GC918-14 03/25/2024 1
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Decrease in funds for Variable Inspections for $9,589.
A net decrease of $9,589.
134,299.11 134,299.11
134,299.11 134,299.11
-9,589 -9,589
124,710.11 124,710.11
06/30/24 06/30/24 -9,589 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 $ 134,299.11
37450104000 JD 132500 37450300 100029 00 $ 9,589.00
Ted A. Goodman, P.G.
Digitally signed by Ted A.
Goodman, P.G.
Date: 2024.03.25 16:25:24 -04'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2024.03.26 07:21:14 -04'00'
Fletch Herrald Digitally signed by Fletch Herrald Date: 2024.03.26 10:42:36 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.03.26 19:27:29 -04'00'
File details come from the government source that posted it. Updated .