CN-370000-GC918-T6CO1.pdf
PDF 1 MB Posted
- Contract number
- GC918
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 1) issued by the Florida Department of Environmental Protection (FDEP) for Alachua County. The document is dated January 28, 2020, and references Task Assignment Number GC918-6. The contractor is Alachua County, represented by Ted Goodman, with Roger Ruiz serving as the FDEP Contract Manager.
The change order increases funding for Variable Inspections by $9,000, raising the total task amount from $118,461 to $127,461. The task completion date remains June 30, 2020, with no extension to the original timeline. Funding is allocated from Organizational Code 37450104000 under E.O. code JD, Object Code 132500, and Special Category 100029, with the total budgeted amount of $127,461.00 charged to Budget Entity 37450300. The change order was approved by Griffin Kolchakian (Budget Representative) on January 29, 2020, and Teresa Booeshaghi (Contractual Authority) on February 5, 2020, with copies directed to the Procurement Section and Bureau of Finance & Accounting.
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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:
GC918-6 01/28/2020 1
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Increase in funds for Variable Inspections for $9,000.
118,461 118,461
118,461 118,461
+9,000 +9,000
127,461 127,461
06/30/20 06/30/20 +9,000 06/30/20
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 $ 127,461.00
Ted A. Goodman, P.G.
Digitally signed by Ted A. Goodman, P.G.
DN: cn=Ted A. Goodman, P.G., o=Alachua County Environmental Protection, ou, email=tgoodman@alachuacounty.us, c=US Date: 2020.01.29 09:52:59 -05'00'
01/29/2020 Roger Ruiz Digitally signed by Roger Ruiz Date: 2020.01.29 10:09:28 -05'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2020.01.29 11:12:36 -05'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2020.02.05 14:53:51 -05'00'
File details come from the government source that posted it. Updated .