CN-370000-GC920-T7CO1.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) dated February 6, 2024. The document modifies an existing task assignment with Broward County, represented by contractor Ali H. Younes. The change order was processed by DEP Contract Manager Roger Ruiz and approved by Budget Representative Tameshia N. Reid and Contractual Authority Jessica Kramer.
The change order decreases the task assignment funding by $12,500, reducing the total task amount from $550,635.34 to $538,135.34. The decrease applies specifically to Variable Inspections within the contract. The task completion date remains unchanged at June 30, 2024. The funding is sourced from Organizational Code 37450104000, using Object Code 132500 under Budget Entity 37450300, Special Category 100029, Year 00. The change order was executed on February 7, 2024, by the contractor and FDEP representatives, with final approval granted on March 4, 2024. Copies of the approved change order were distributed to the Procurement Section (MS93) and 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:
GC920-7 02/06/2024 1
BROWARD COUNTY
Ali H. Younes
Roger Ruiz
Decrease in funds for Variable Inspections for $12,500.
A net decrease of $12,500.
550,635.34 550,635.34
550,635.34 550,635.34
-12,500 -12,500
538,135.34 538,135.34
06/30/24 06/30/24 -12,500 06/30/24
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 $ 550,635.34
37450104000 JD 132500 37450300 100029 00 -$ 12,500.00
Digitally signed by ALI YOUNES Date: 2024.02.07 07:47:13 -05'00' 02/07/2024 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2024.02.07 07:55:15 -05'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.02.07 08:45:42 -05'00'
Jessica Kramer Digitally signed by Jessica Kramer Date: 2024.03.04 10:06:48 -05'00'
File details come from the government source that posted it. Updated .