CN-370000-GC920-T3CO1.pdf
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- Contract number
- GC920
- 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, for Task Assignment Number GC920-3 with Broward County. The contractor is represented by Ali H. Younes, and the FDEP Contract Manager is Roger Ruiz. The change order was approved by Griffin Kolchakian (Budget Representative) and Teresa Booeshaghi (Contractual Authority) on January 29, 2020, and February 5, 2020, respectively.
The change order increases the total task amount by $23,900, consisting of $900 for travel allotment and $23,000 for variable inspections. The original task amount of $453,760 is increased to $477,660 with all change orders applied. The task completion date remains unchanged at June 30, 2020. The funding is allocated to Organization Code 37450104000 under E.O. JD with Object Code 132500, Budget Entity 37450300, Special Category 100029, with the total authorized amount of $477,660.00.
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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:
GC920-3 01/28/2020 1
BROWARD COUNTY
Ali H. Younes
Roger Ruiz
The total increase in funds for GC920-3 Broward County is $23,900.
$900 for Travel Allotment.
$23,000 for Variable Inspections.
453,760 453,760
453,760 453,760
+23,900 +23,900
477,660 477,660
06/30/20 06/30/20 +23,900 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 $ 477,660.00
Digitally signed by ALI YOUNES Date: 2020.01.29 08:16:21 -05'00' 01/29/2020 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2020.01.29 08:42:15 -05'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2020.01.29 11:21:38 -05'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2020.02.05 14:35:21 -05'00'
File details come from the government source that posted it. Updated .