CN-370000-GC921-T5CO1.pdf
PDF 639 KB Posted
- Contract number
- GC921
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection. The document involves a contract with Sarasota County, with Matthew Osterhoudt serving as the Contractor Representative and Roger Ruiz as the DEP Contract Manager. The change order is identified as Change Order No. 1 for Task Assignment GC921-5.
The change order increases funding for Variable Inspections by $4,000, raising the total task amount from $116,003 to $120,003. The task completion date remains fixed at June 30, 2022. Funding is allocated through Org. Code 37450104000 under Object Code 132500, with a Budget Entity of 37450300 and Special Category 100029, resulting in a total budgeted amount of $120,003.00. The change order requires approval signatures from the Contract Manager, Budget Representative, and Contractual Authority, with copies distributed to the Procurement Section and Bureau of Finance & Accounting.
View the file
Other files
Show all 22
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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:
GC921-5 1
SARASOTA COUNTY
Matthew Osterhoudt
Roger Ruiz
Increase in funds for Variable Inspections for $4,000.
A net increase of $4,000.
116,003 116,003
116,003 116,003
+4,000 +4,000
120,003 120,003
06/30/22 06/30/22 +4,000 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 $ 120,003.00
File details come from the government source that posted it. Updated .