CN-370000-GC919-T3CO1.pdf
PDF 654 KB 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) dated July 18, 2019. The document pertains to a task assignment with Collier County, represented by contractor Phil Snyderburn, with Roger Ruiz serving as the DEP Contract Manager. The change order is identified as Change Order No. 1 under Task Assignment Number GC919-3.
The change order increases the task assignment funding by $13,879.00 specifically for Variable Inspections. The original task amount was $100,073.00, resulting in a revised total task amount of $113,952.00. The task completion date remains June 30, 2020, with no extension to the schedule. Funding is allocated from Org. Code 37450104000, Object Code 132500, Budget Entity 37450300, Special Category 100029, in the amount of $113,952.00. The change order was approved by Budget Representative Griffin Kolchakian and Contractual Authority Teresa Booeshaghi on July 18 and July 22, 2019, respectively.
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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:
GC919-3 07/18/2019 1
COLLIER COUNTY
Phil Snyderburn
Roger Ruiz
Increase of Funds for Variable Inspections in the amount of $13,879.00.
100,073.00 100,073.00
100,073.00 100,073.00
+13,879.00 +13,879.00
113,952.00 113,952.00
06/30/20 06/30/20 +13,879.00 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 $ 113,952.00
Phil Snyderburn Digitally signed by Phil Snyderburn Date: 2019.07.18 14:27:23 -04'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2019.07.18 15:38:20 -04'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2019.07.18 15:56:09 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2019.07.22 12:09:38 -04'00'
File details come from the government source that posted it. Updated .