CN-370000-GC919-T3CO2.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) on January 28, 2020. The document modifies an existing task assignment with Collier County, with Phil Snyderburn serving as the contractor representative and Roger Ruiz as the DEP Contract Manager. The change order is numbered 2 and references Task Assignment Number GC919-3.
The change order increases funding for variable inspections by $5,400, raising the total task amount from $113,952 to $119,352. The task completion date remains unchanged at June 30, 2020. The funding is allocated through Organizational Code 37450104000 with Object Code 132500, Budget Entity 37450300, and Special Category 100029, with the full amount of $119,352.00 charged to year 00. 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:
GC919-3 01/28/2020 2
COLLIER COUNTY
Phil Snyderburn
Roger Ruiz
Increae in funds for Variable Inspections for $5,400.
113,952 113,952
113,952 113,952
+5,400 +5,400
119,352 119,352
06/30/20 06/30/20 +5,400 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 $ 119,352.00
Phil Snyderburn Digitally signed by Phil Snyderburn Date: 2020.01.29 09:07:27 -05'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2020.01.29 09:58:54 -05'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2020.01.29 11:35:43 -05'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2020.02.05 14:54:23 -05'00'
File details come from the government source that posted it. Updated .