CN-370000-GC920-T4CO1.pdf
PDF 1 MB Posted
- Contract number
- GC920
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection (FDEP) for Task Assignment Number GC920-4 with Broward County. The change order was executed on June 8, 2021, and was approved by FDEP Contract Manager Roger Ruiz and Contractor Representative Ali H. Younes. The document was further approved by Monica J. Brady (Budget Representative) and Teresa Booeshaghi (Contractual Authority) on June 9, 2021.
The change order modifies the completion deadline for routine compliance inspections of storage tank systems at 649 facilities within Broward County, identified in Exhibit #1. The original deadline of May 31, 2021, was extended to June 30, 2021. The task amount remains unchanged at $477,660.00, which is funded through Org. Code 37450104000, Object Code 132500, Budget Entity 37450300, and Special Category 100029. No increase or decrease in the task amount or funding was associated with this change order; the modification affected only the timeline for completion.
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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:
GC920-4 1
BROWARD COUNTY
Ali H. Younes
Roger Ruiz
This change revises the sentence in Task Assignment #4 for DEP Contract GC920-4, reading:
"Conduct routine compliance inspections for storage tank systems at the 649 facilities within Broward County, identified in Exhibit #1, by May 31, 2021.", to read:
"Conduct routine compliance inspections for storage tank systems at the 649 facilities within Broward County, identified in Exhibit #1, by June 30, 2021."
477,660 477,660
06/30/21 06/30/21
06/30/21
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
ALI YOUNES Digitally signed by ALI YOUNES Date: 2021.06.08 07:50:32 -04'00' 06/08/2021 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2021.06.08 08:30:18 -04'00'
Monica J. Brady Digitally signed by Monica J.
Brady Date: 2021.06.09 09:14:10 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2021.06.09 09:48:14 -04'00'
File details come from the government source that posted it. Updated .