CN-370000-GC918-T1CO3.pdf

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Attached to
Master Agreement FL|GC918|39eae9529775b6821fd2982566be24b1
Contract number
GC918
Issued by
Florida

About this file

This is a Task Assignment Change Order Form (Change Order No. 3) issued by the Florida Department of Environmental Protection (FDEP) on May 31, 2018, for a task assignment numbered GC918-1 with Alachua County. The contractor representative is Ted Goodman, and the FDEP contract manager is Roger Ruiz. The change order was approved by Jennifer Vickers (Budget Representative) and Tim J. Bahr (Contractual Authority) on June 6, 2018.

The change order reduces routine inspections assigned to Alachua County from 533 to 509 inspections, representing a net decrease of 24 routine inspections and a corresponding cost reduction of $12,372.00. The task amount prior to this change order was $332,947.11, reducing to $320,575.11 with all change orders applied. The original task completion date of June 30, 2018 remains unchanged. Funding is allocated from Org. Code 37450104000 under E.O. code JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, for fiscal year 2018, with a total task amount of $320,575.11.

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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:

GC918-1 05/31/2018 3

ALACHUA COUNTY

Ted Goodman

Roger Ruiz

Reduction of 24 Routine Inspections, from 533 Routine Inspections assigned, to 509 Routine Inspections.

A net decrease of $12,372.00.

345,494.86 345,494.86

332,947.11 332,947.11

(12,372.00) (12,372.00)

320,575.11 320,575.11

06/30/18 06/30/18 (12,372.00) 06/30/18

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 2018 $ 320,575.11

Ted A. Goodman Digitally signed by Ted A. Goodman DN: cn=Ted A. Goodman, o=ACEPD, ou, email=tgoodman@alachuacounty.us, c=US Date: 2018.06.01 12:29:23 -04'00'

06/01/2018 Roger Ruiz Digitally signed by Roger Ruiz Date: 2018.06.04 10:42:58 -04'00'

Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.06.06 10:00:30 -04'00'

Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.06.06 10:48:54 -04'00'

File details come from the government source that posted it. Updated .