CN-370000-GC922-T1CO1.pdf

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Attached to
Master Agreement FL|GC922|3878a620099fd3faf779cdfc1121e6f0
Contract number
GC922
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. The document modifies an existing contract with Pinellas County, with Christine Frankford serving as the Contractor Representative and Roger Ruiz as the DEP Contract Manager. The change order was approved by Jennifer Vickers (Budget Representative) and John Truitt (Contractual Authority) on August 7, 2017 and August 11, 2017, respectively.

The change order increases the fee schedule for routine inspections from $510.40 to $515.50 per inspection, representing a net increase of $5.10 per inspection. This 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 $3,459.84, bringing the total task amount from $346,255.36 to $349,715.20. The task completion date remains June 30, 2018. Funding is sourced from Org. Code 37450104000 under E.O. code JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, with the full amount of $349,715.20 allocated for the fiscal year ending 00.

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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:

GC922-1 08/02/2017 1

PINELLAS COUNTY

Christine Frankford

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.

346,255.36 346,255.36

346,255.36 346,255.36

3,459.84 3,459.84

349,715.20 349,715.20

06/30/18 06/30/18 3,459.84 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 $ 349,715.20

Christine Frankford

Digitally signed by Christine Frankford DN: cn=Christine Frankford, o=FDOH - Pinellas, ou=Division of Disease Control and Health Protection, email=joseph.sowers@flhealth.gov, c=US Date: 2017.08.04 10:14:21 -04'00'

08/04/2017 Roger Ruiz Digitally signed by Roger Ruiz Date: 2017.08.07 09:23:21 -04'00'

Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2017.08.07 14:27:38 -04'00'

08/07/2017

John Truitt Digitally signed by John Truitt Date: 2017.08.11 14:58:56 -04'00'

File details come from the government source that posted it. Updated .