CN-370000-GC919-T2CO1.pdf
PDF 1 MB Posted
- Contract number
- GC919
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) on July 19, 2018. The document pertains to Task Assignment Number GC919-2 with Collier County as the contractor. Phil Snyderburn serves as the contractor representative, while Roger Ruiz is the FDEP Contract Manager. The change order has been approved by the Florida Department of Environmental Protection through signatures by Fletcher Herrald (Contract Manager), Jennifer Vickers (Budget Representative), and Tim J. Bahr (Contractual Authority).
Change Order No. 1 reflects an updated Attachment A - Scope of Work with an original task amount of $104,670.00 and a task completion date of June 30, 2019. The funding is allocated through Org. Code 37450104000 under E.O. code JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, and Year 00. No net increase or decrease in task amount or task period is indicated, as both the completion date prior to the change and the completion date with all change orders remain June 30, 2019. The $104,670.00 has been distributed to the Bureau of Finance & Accounting and the Procurement Section as required.
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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:
GC919-2 07/19/2018 1
COLLIER COUNTY
Phil Snyderburn
Roger Ruiz
Updated Attachment A - Scope of Work
104,670.00
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 $ 104,670.00
Phil Snyderburn Digitally signed by Phil Snyderburn Date: 2018.08.01 15:29:45 -04'00' Fletcher Herrald Digitally signed by Fletcher Herrald
Date: 2018.08.01 15:33:11 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.08.02 12:26:44 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.08.02 13:09:18 -04'00'
File details come from the government source that posted it. Updated .