CN-370000-GC921-T1CO1.pdf
PDF 1 MB Posted
- Contract number
- GC921
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 1) issued by the Florida Department of Environmental Protection (FDEP) on August 2, 2017, for Task Assignment GC921-1 with Sarasota County. The change order was executed by contractor representative John Hickey, PE, and approved by FDEP Contract Manager Roger Ruiz, along with Budget Representative Jennifer Vickers and Contractual Authority Tim J. Bahr.
The change order increases the unit price for Routine Inspection services from $510.40 to $515.50 per inspection, representing a net increase of $5.10 per inspection. The price increase became effective September 1, 2017, with all inspections conducted through August 31, 2017, paid at the original rate of $510.40. The net increase in task amount is $1,115.63, raising the total task amount from $111,650.00 to $112,765.63. The task completion date remains June 30, 2018. Funding for this change order is allocated from Org. Code 37450104000 under Object Code 132500 with Budget Entity 37450300 and Special Category 100029, with a total obligation of $112,765.63.
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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:
GC921-1 08/02/2017 1
SARASOTA COUNTY
John Hickey, PE
Roger Ruiz
Amount increase per Routine Inspection from $510.40 to $515.50.
A net increase of $5.10 per Routine Inspection.
The increase will become effective September 1, 2017. All inspections conducted through August 31, 2017, will be paid at the rate of $510.40.
111,650.00 111,650.00
111,650.00 111,650.00
1,115.63 1,115.63
112,765.63 112,765.63
06/30/18 06/30/18 1,115.63 06/30/18
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 $ 112,765.63
Digitally signed by John Hickey Date: 2017.08.07 15:50:43 -04'00'
08/07/2017 Roger Ruiz Digitally signed by Roger Ruiz Date: 2017.08.07 16:06:44 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2017.08.07 16:34:03 -04'00'
08/07/2017
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2017.08.08 16:59:20 -04'00'
File details come from the government source that posted it. Updated .