CN-370000-GC919-T3CO3.pdf
PDF 656 KB Posted
- Contract number
- GC919
- Issued by
- Florida
About this file
This document is a Task Assignment Change Order Form (Change Order No. 3) issued by the Florida Department of Environmental Protection on May 4, 2020. The change order involves Collier County as the contractor, with Phil Snyderburn serving as the Contractor Representative and Roger Ruiz as the DEP Contract Manager. The task assignment is identified as GC919-3.
The change order increases funding for Routine Compliance Inspections and Variable Inspections by $8,318.08. The original task amount was $113,952, which had been increased to $119,352 prior to this change order. The net increase of $8,318.08 brings the total task amount with all change orders to $127,670.08. The task completion date remains unchanged at June 30, 2020. The funding is allocated to Organizational Code 37450104000 under Object Code 132500, with Budget Entity 37450300, Special Category 100029, and Year 00. All required signatures from the contractor, DEP Contract Manager, Budget Representative (Fletch Herrald), and Contractual Authority (Teresa Booeshaghi) were executed digitally on May 5, 2020.
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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 05/04/2020 3
COLLIER COUNTY
Phil Snyderburn
Roger Ruiz
Increase in funds for Routine Compliance Inspections and Variable Inspections for $8,318.08.
113,952 113,952
119,352 119,352
+8,318.08 +8,318.08
127,670.08 127,670.08
06/30/20 06/30/20 +8,318.08 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 $ 127,670.08
snyderburn_p Digitally signed by snyderburn_p Date: 2020.05.05 09:21:49 -04'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2020.05.05 12:25:10 -04'00'
Fletch Herrald Digitally signed by Fletch Herrald Date: 2020.05.05 15:43:15 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2020.05.05 15:46:48 -04'00'
File details come from the government source that posted it. Updated .