CN-370000-GC918-T3CO1.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 contract with Alachua County. The change order, numbered 1, was executed on July 19, 2018, and is managed by FDEP Contract Manager Roger Ruiz and Alachua County representative Ted Goodman. The document requires approval signatures from the contractor, FDEP, budget representatives, and contractual authority, all of which were obtained in August 2018.
The change order pertains to an updated Attachment A—Scope of Work for Task Assignment GC918-3. The original task amount of $322,485.00 maintains the same completion date of June 30, 2019, with no net increase or decrease in the task amount or task period indicated in this change order. Funding is allocated through Org. Code 37450104000 with Object Code 132500, Budget Entity 37450300, and Special Category 100029, with the full amount of $322,485.00 charged to Year 00. The document was executed by contractor representative Ted A. Goodman on July 17, 2018, and approved by FDEP Contract Manager Fletcher Herrald, Budget Representative Jennifer Vickers, and Contractual Authority Tim J. Bahr on August 1, 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:
GC918-3 07/19/2018 1
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Updated Attachment A - Scope of Work
322,485.00
06/30/19 06/30/19
06/30/19
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 $ 322,485.00
Ted A. Goodman Digitally signed by Ted A. Goodman DN: cn=Ted A. Goodman, o=ACEPD, ou, email=tgoodman@alachuacounty.us, c=US Date: 2018.07.27 09:41:37 -04'00'
07/17/2018 Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2018.08.01 14:32:19 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.08.01 14:44:21 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.08.01 14:51:56 -04'00'
File details come from the government source that posted it. Updated .