CN-370000-GC920-T2CO3.pdf
PDF 669 KB Posted
- Contract number
- GC920
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 3) issued by the Florida Department of Environmental Protection on May 16, 2019. The document modifies an existing task assignment (GC920-2) with Broward County, represented by contractor Ali H. Younes. The DEP Contract Manager is Roger Ruiz.
The change order increases the task assignment funding by $30,000.00 to cover variable inspections. The original task amount was $443,705.00, bringing the total task amount with all change orders to $473,705.00. The task completion date remains June 30, 2019, with no extension to the original timeline. The funding is allocated to Org. Code 37450104000 under Object Code 132500, with Budget Entity 37450300, Special Category 104138, and Year 00, totaling $473,705.00. The change order was approved by Fletcher Herrald, serving as both Budget Representative and Contractual Authority.
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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:
GC920-2 05/16/2019 3
BROWARD COUNTY
Ali H. Younes
Roger Ruiz
Increase of Funds for Variable Inspections in the amount of $30,000.00.
443,705.00 443,705.00
443,705.00 443,705.00
30,000.00 30,000.00
473,705.00 473,705.00
06/30/19 06/30/19 30,000.00 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 104138 00 $ 473,705.00
Digitally signed by ALI YOUNES Date: 2019.05.16 10:36:40 -04'00' 05/16/2019 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2019.05.16 13:19:20 -04'00'
Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2019.05.16 13:25:42 -04'00'
Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2019.05.16 13:25:58 -04'00'
File details come from the government source that posted it. Updated .