CN-370000-GC918-T3CO4.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 June 17, 2019. The document modifies an existing task assignment (GC918-3) with Alachua County. The contractor representative is Ted Goodman, and the FDEP contract manager is Roger Ruiz. The change order was approved by Griffin Kolchakian (Budget Representative) and Teresa Booeshaghi (Contractual Authority).
The change order reduces routine compliance inspections from 533 facilities to 517 facilities, resulting in a net reduction of $3,720.00 in task funding. The reduction reflects an $8,720.00 decrease for 16 eliminated routine compliance inspections offset by a $5,000 increase for variables. The original task amount was $322,485.00, which had been increased to $346,485.00 prior to this change order. With this modification, the task amount with all change orders is now $342,765.00. The completion date remains unchanged at June 30, 2019. Funding is allocated from Organization Code 37450104000 under Object Code 132500, Budget Entity 37450300, Special Category 100029, for a total of $342,765.00.
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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 06/17/2019 4
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Reduction of 16 Routine Compliance Inspections, in the amount of $8,720.00 and a $5,000 increase for variables results in this $3,720 funding reduction. The routine inspections are going from 533 facilities to 517 facilities.
322,485.00 322,485.00
346,485.00 346,485.00
-3,720.00 -3,720.00
342,765.00 342,765.00
06/30/19 06/30/19 -3,720.00 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 $ 342,765.00
Ted A. Goodman Digitally signed by Ted A. Goodman DN: cn=Ted A. Goodman, o=ACEPD, ou, email=tgoodman@alachuacounty.us, c=US Date: 2019.06.17 10:13:12 -04'00'
06/17/2019 Roger Ruiz Digitally signed by Roger Ruiz Date: 2019.06.17 10:19:59 -04'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2019.06.17 11:11:58 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2019.06.17 12:54:31 -04'00'
File details come from the government source that posted it. Updated .