CN-370000-GC920-T5CO1.pdf
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- Contract number
- GC920
- Issued by
- Florida
About this file
This document is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection (FDEP) on June 9, 2022. The change order pertains to a task assignment with Broward County, represented by contractor Ali H. Younes. The FDEP contract manager is Roger Ruiz. The change order has been approved by Budget Representative Tameshia N. Reid and Contractual Authority John Truitt.
The change order increases funding for Variable Inspections by $20,000, raising the total task amount from $462,567 to $482,567. The task completion date remains June 30, 2022, with no extension to the timeline. The funding is sourced from organizational code 37450104000 with object code 132500, budget entity 37450300, special category 100029, and year 00, totaling $482,567.00. The change order was executed with digital signatures from all required parties and distributed to the Procurement Section (MS93) and the Bureau of Finance & Accounting (MS78).
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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:
GC920-5 06/09/2022 1
BROWARD COUNTY
Ali H. Younes
Roger Ruiz
Increase in funds for Variable Inspections for $20,000.
A net increase of $20,000.
462,567 462,567
462,567 462,567
+20,000 +20,000
482,567 482,567
06/30/22 06/30/22 +20,000 06/30/22
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 $ 482,567.00
Digitally signed by ALI YOUNES Date: 2022.06.09 11:29:13 -04'00' Adobe Acrobat version:
2022.001.20117
06/09/2022 Roger Ruiz Digitally signed by Roger Ruiz Date: 2022.06.09 11:45:11 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.06.10 09:47:41 -04'00'
John Truitt Digitally signed by John Truitt Date: 2022.06.10 10:40:16 -04'00'
File details come from the government source that posted it. Updated .