CN-370000-GC920-T6CO1.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 on March 21, 2023. The change order involves Broward County as the contractor, with Ali H. Younes serving as the Contractor Representative and Roger Ruiz as the DEP Contract Manager. The task assignment number is GC920-6, and this constitutes Change Order No. 1.
The change order authorizes an increase in funds for Ethanol/Biodiesel Inspections in the amount of $419. The original task amount of $481,712 is increased by $419, resulting in a revised total task amount of $482,131. The task completion date remains June 30, 2023, with no extension to the timeline. The funding is allocated across two budget categories: $481,712 from E.O. JD (Special Category 100029, Year 00) and $419 from E.O. JG (Special Category 087889, Year 23), both charged to Organization Code 37450104000, Object Code 132500, and Budget Entity 37450300. The change order was approved by Tameshia N. Reid (Budget Representative) on March 22, 2023, and Jessica Kramer (Contractual Authority) on March 27, 2023.
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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:
GC920-6 03/21/2023 1
BROWARD COUNTY
Ali H. Younes
Roger Ruiz
Increase in funds for Ethanol/Biodiesel Inspections for $419.
A net increase of $419.
481,712 481,712
481,712 481,712
+419 +419
482,131 482,131
06/30/23 06/30/23 +419 06/30/23
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 $ 481,712.00
37450104000 JG 132500 37450300 087889 23 $ 419.00
Digitally signed by ALI YOUNES Date: 2023.03.21 15:25:36 -04'00' 03/21/2023 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2023.03.22 07:58:47 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2023.03.22 09:58:25 -04'00'
Jessica Kramer Digitally signed by Jessica Kramer Date: 2023.03.27 07:59:12 -04'00'
File details come from the government source that posted it. Updated .