CN-370000-GC918-T1CO4.pdf
PDF 654 KB Posted
- Contract number
- GC918
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 4) issued by the Florida Department of Environmental Protection on June 12, 2018. The document involves Alachua County as the contractor, with Ted Goodman serving as the Contractor Representative and Roger Ruiz as the DEP Contract Manager. The task assignment number is GC918-1, and the change order was approved by Jennifer Vickers (Budget Representative) and Tim J. Bahr (Contractual Authority).
The change order reduces the scope of work by one routine inspection, decreasing the total from 509 routine inspections to 508 routine inspections. This reduction resulted in a net decrease of $515.50 to the task amount. The original task amount was $345,494.86, and prior to this change order, the task amount was $320,575.11. With this change order applied, the final task amount is $320,059.61. The task completion date remains unchanged at June 30, 2018. Funding for this work is allocated from Org. Code 37450104000 under E.O. JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, in fiscal year 2018, with a total approved amount of $320,059.11.
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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 06/12/2018 4
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Reduction of 1 Routine Inspections, from 509 Routine Inspections assigned, to 508 Routine Inspections.
A net decrease of $515.50
345,494.86 345,494.86
320,575.11 320,575.11
(515.50) (515.50)
320,059.61 320,059.61
06/30/18 06/30/18 (515.50) 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 $ 320,059.11
Ted A. Goodman Digitally signed by Ted A. Goodman DN: cn=Ted A. Goodman, o=ACEPD, ou, email=tgoodman@alachuacounty.us, c=US Date: 2018.06.12 13:44:52 -04'00'
06/12/2018 Roger Ruiz Digitally signed by Roger Ruiz Date: 2018.06.12 13:47:10 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.06.13 08:18:39 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.06.13 08:20:36 -04'00'
File details come from the government source that posted it. Updated .