CN-370000-GC918-T14CO3.pdf
PDF 302 KB Posted
- Contract number
- GC918
- Issued by
- Florida
About this file
Task Assignment Change Order Summary
This is a Task Assignment Change Order Form (Form OOO-012) issued by the Florida Department of Environmental Protection (FDEP) for a task assignment with Alachua County. The change order, dated June 5, 2024, is Change Order No. 3 to Task Assignment GC918-14. The contractor is Alachua County, represented by Ted Goodman, with Roger Ruiz serving as the FDEP Contract Manager.
The change order increases funding for Variable Inspections by $3,500, resulting in a net increase to the task amount from $128,610.11 to $132,110.11. The original task amount was $134,299.11, and the fee schedule reflects the cumulative adjustments across multiple change orders totaling $3,500 in additional funds. The task completion date remains June 30, 2024, with no changes to the timeline. Funding is allocated from Organization Code 37450104000 under Object Code 132500, Budget Entity 37450300, Special Category 100029, and Year 00. The change order was approved by Budget Representative Tameshia N. Reid and Contractual Authority Teresa Booeshaghi on June 6, 2024, with copies distributed to the Procurement Section (MS93) and 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 06/05/2024 3
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Increase in funds for Variable Inspections for $3,500.
A net increase of $3,500.
134,299.11 134,299.11
128,610.11 128,610.11
+3,500 +3,500
132,110.11 132,110.11
06/30/24 06/30/24 +3,500 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
37450104000 JD 132500 37450300 100029 00 $ 3,900.00
37450104000 JD 132500 37450300 100029 00 $ 3,500.00
Ted A. Goodman, P.G.
Digitally signed by Ted A.
Goodman, P.G.
Date: 2024.06.05 15:50:16 -04'00'
06/05/2024 Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.06.06 07:42:31 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.06.06 08:46:20 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.06.06 12:07:36 -04'00'
File details come from the government source that posted it. Updated .