CN-370000-GC918-T2CO4.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 (FDEP) on May 31, 2018, for Task Assignment Number GC918-2. The contractor is Alachua County, represented by Ted Goodman, with Roger Ruiz serving as the DEP Contract Manager.
The change order reduces the scope of routine inspections assigned to Alachua County from 191 to 189 inspections, resulting in a net decrease of $1,031.00 to the task amount. The task amount prior to this change order was $117,044.84, and with this reduction, the total task amount with all change orders is $116,013.84. The task completion date remains June 30, 2018. Funding is allocated from Organizational Code 37450104000 under object code 132500 with budget entity 37450300, special category 100029, for fiscal year 2018. The change order was approved by Jennifer Vickers (Budget Representative) and Tim J. Bahr (Contractual Authority) on June 6, 2018.
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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 05/31/2018 4
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Reduction of 2 Routine Inspections, from 191 Routine Inspections assigned, to 189 Routine Inspections.
A net decrease of $1,031.00
123,807.73 123,807.73
117,044.84 117,044.84
(1,031.00) (1,031.00)
116,013.84 116,013.84
06/30/18 06/30/18 (1,031.00) 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 $ 116,013.84
Ted A. Goodman Digitally signed by Ted A. Goodman DN: cn=Ted A. Goodman, o=ACEPD, ou, email=tgoodman@alachuacounty.us, c=US Date: 2018.06.01 12:31:36 -04'00'
06/01/2018 Roger Ruiz Digitally signed by Roger Ruiz Date: 2018.06.04 10:50:12 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.06.06 10:01:28 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.06.06 10:49:23 -04'00'
File details come from the government source that posted it. Updated .