CN-370000-GC918-TACO 3.pdf
PDF 654 KB 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 on June 1, 2021. The change order modifies Task Assignment Number GC918-7 for Alachua County. The contractor is represented by Ted Goodman, with Roger Ruiz serving as the DEP Contract Manager. The document has been approved by budget representative Monica J. Brady and contractual authority Teresa Booeshaghi.
The change order reduces the scope of routine compliance inspections from 526 to 525 inspections per request from GC918-7 Alachua. This reduction results in a net decrease of $515.50 to the task amount, bringing the total task amount from $326,903.50 to $326,388.00. The completion date remains unchanged at June 30, 2021. The funding is allocated from organizational code 37450104000 under object code 132500, budget entity 37450300, special category 100029, in the amount of $326,388.00. All required signatures were executed on June 2-3, 2021, and copies were distributed 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:
GC918-7 06/01/2021 3
ALACHUA COUNTY
Ted Goodman
Roger Ruiz
Reduction of 1 Routine Compliance Inspection, from 526 to 525 Routine Compliance Inspections per request from GC918-7 Alachua.
A net decrease of $515.50.
326,903.50 326,903.50
326,903.50 326,903.50
-515.50 -515.50
326,388 326,388
06/30/21 06/30/21 -515.50 06/30/21
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 $ 326,388.00
Ted A. Goodman, P.G.
Digitally signed by Ted A.
Goodman, P.G.
Date: 2021.06.02 08:44:58 -04'00'
06/02/2021 Roger Ruiz Digitally signed by Roger Ruiz Date: 2021.06.02 08:57:04 -04'00'
Monica J. Brady Digitally signed by Monica J.
Brady Date: 2021.06.03 10:33:01 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2021.06.03 10:39:42 -04'00'
File details come from the government source that posted it. Updated .