CN-370000-GC922-T4.pdf

DEP Contract No. GC922, Attachment C, Page 1 of 3

Attachment C

Florida Department of Environmental Protection Task Assignment Notification Form for PINELLAS COUNTY

Contract No. GC922 Task No. 4 Amendment No. ____ Date June 18, 2018

Performance Period: Effective the date of execution of this Task Assignment or July 1, 2018, whichever is later, and shall remain in effect until June 30, 2019.

Description:

The Contractor shall complete the following services in accordance with the requirements in DEP Contract No. GC922:

Provide training for inspectors conducting Compliance Routine and Variable inspections at County and District Offices, and other locations as directed and approved by the Department.

Utilize the new Contractual Services Invoice Form for all monthly invoices (Guidance Document E) https://floridadep.gov/waste/permitting-compliance-assistance/documents/e-contractual-services-invoice

Payment Schedule:

Compensation will occur after training has concluded. Contractor must provide venue location, list of inspectors attending training, travel documentation, hotel documentation, per diem, mileage and miscellaneous expenses in accordance to the State of Florida and as allowed under Florida Department of Health Guidelines.

Invoice Procedure:

Submission of invoice shall be via email to: STR_Invoices@dep.state.fl.us. The email shall consist of a single PDF package.

Remainder of Page Intentionally Left Blank https://floridadep.gov/waste/permitting-compliance-assistance/documents/e-contractual-services-invoice mailto:STR_Invoices@dep.state.fl.us

DEP Contract No. GC909, Attachment C, Page 2 of 3

TASK ASSIGNMENT FORM

Required Signatures: Adobe Signature

FDEP Contract No: Task Assignment No: Date: DEP Task Manager:

Project:

Contractor Name:

Contractor Representative: Phone: Email:

FDEP Contract Manager: Phone: Email:

Task Description:

Deliverables:

Performance Measures:

Financial Consequences:

GC922 4 Roger Ruiz

GC922-4

Pinellas County Health Department

Chuck Minor, REHS (727) 538-4336 Charles.Minor@flhealth.gov

Roger Ruiz 850-245-8854 roger.ruiz@dep.state.fl.us

Provide training for inspectors conducting Compliance Routine and Variable inspections at County and District Offices, and other locations as directed and approved by the Department.

Compensation will occur after training has concluded. Contractor must provide venue location, list of inspectors attending training, travel documentation, hotel documentation, per diem, mileage and miscellaneous expenses in accordance to the State of Florida and as allowed under Florida Department of Health Guidelines.

The Contractor shall develop the training according the need and level of training required by a County or District Office as directed and approved by the Department.

No payment will be made for deliverables deemed unsatisfactory by the Department. In the event that a deliverable is deemed unsatisfactory by the Department, the Contractor shall re-perform the services needed for submittal of a satisfactory deliverable, at no additional cost to Department, within thirty (30) days of being notified of the unsatisfactory deliverable.

If a satisfactory deliverable is not submitted within the specified time frame, the Department may, in its sole discretion: 1) assess liquidated damages if specified in the Contract or its attachments; 2) request from the Contractor agreement to a reduction in the amount payable; 3) suspend all Work until satisfactory performance is achieved, or 4) terminate the Contract for failure to perform.

DEP Contract No. GC909, Attachment C, Page 3 of 3

TASK ASSIGNMENT FORM

Schedule:

Start Date: Completion Date:

Fixed Price Cost: Cost Reimbursement not to exceed:

Total Task Value:

Signatures and Date:

1._________________________________ __________________________________ __________________ Task Manager, FDEP Signature Date

2._________________________________ __________________________________ __________________ Contract Manager, FDEP Signature Date

3. _________________________________ __________________________________ __________________ Budget Representative, FDEP Signature Date

4. _________________________________ __________________________________ __________________ Contractor, Contract Manager Signature Date

5. _________________________________ __________________________________ __________________ Contract Authority, FDEP Signature Date

Encumbrance Information:

Budget Entity

Project

Grant

Org Code Category & Year

Fund Special Category

Object Code

EO Amount

Total:

07/01/2018 06/30/2019

$10,000.00

N/A

Roger Ruiz Roger Ruiz Digitally signed by Roger Ruiz Date: 2018.06.25 15:34:32 -04'00'

Jennifer Vickers Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.06.25 16:48:33 -04'00'

Chuck Minor, REHS Charles Minor Digitally signed by Charles Minor Date: 2018.06.25 12:21:04 -04'00' 06/25/2018

Fletcher Herrald Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2018.06.26 18:34:35 -04'00'

37450300 GC922 37450104000 00 212001 100029 132500 JD $10000.00

10000