CN-370000-GC918-T201.pdf
PDF 1 MB Posted
- Contract number
- GC918
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection (FDEP) for a task assignment with Alachua County. The change order, dated August 2, 2017, was executed by Ted Goodman (Contractor Representative) and Roger Ruiz (DEP Contract Manager). The document was approved by Jennifer Vickers (Budget Representative) and Tim J. Bahr (Contractual Authority) on August 7, 2017.
The change order modifies the pricing structure for routine inspections under Task Assignment Number GC918-2, increasing the per-inspection rate from $510.40 to $515.50, representing a net increase of $5.10 per routine inspection. The increase became effective September 1, 2017, with all inspections conducted through August 31, 2017, paid at the original rate of $510.40. This modification increased the total task amount from $123,807.73 to $125,044.84, a net increase of $1,237.11. The task completion date remained June 30, 2018. Funding for the change order is allocated to Org. Code 37450104000 under Object Code 132500, Budget Entity 37450300, Special Category 100029, with a total amount of $125,044.84.
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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:
GC918-2 08/02/2017 1
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Amount increase per Routine Inspection from $510.40 to $515.50.
A net increase of $5.10 per Routine Inspection.
The increase will become effective September 1, 2017. All inspections conducted through August 31, 2017, will be paid at the rate of $510.40.
123,807.73 123,807.73
123,807.73 123,807.73
1,237.11 1,237.11
125,044.84 125,044.84
06/30/18 06/30/18 1,237.11 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 00 $ 125,044.84
Ted A. Goodman Digitally signed by Ted A. Goodman DN: cn=Ted A. Goodman, o=ACEPD, ou, email=tgoodman@alachuacounty.us, c=US Date: 2017.08.04 07:28:44 -04'00'
08/04/2017 Roger Ruiz Digitally signed by Roger Ruiz Date: 2017.08.07 08:47:05 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2017.08.07 09:21:43 -04'00'
08/07/2017
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2017.08.07 17:09:02 -04'00'
File details come from the government source that posted it. Updated .