CN-370000-GC922-T5CO1.pdf
PDF 1 MB Posted
- Contract number
- GC922
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection for a task assignment with Pinellas County. The change order was executed on January 29, 2020, and approved on February 3-5, 2020. The primary parties involved are the contractor (Pinellas County), represented by Charles Minor, and the Florida Department of Environmental Protection, with Roger Ruiz serving as the DEP Contract Manager.
The change order increases funding for Variable Inspections by $13,000, raising the total task amount from $370,715 to $383,715. The task completion date remains June 30, 2020, with no extension to the timeline. The funding modification is tracked under Organizational Code 37450104000, with an E.O. designation of JD, Object Code 132500, and Budget Entity 37450300. The full revised task amount of $383,715.00 is allocated under Special Category 100029 and Year 00. The change order was approved by Budget Representative Griffin Kolchakian and Contractual Authority Teresa Booeshaghi, with copies 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:
GC922-5 01/29/2020 1
PINELLAS COUNTY
Charles Minor
Roger Ruiz
Increase in funds for Variable Inspections for $13,000.
370,715 370,715
370,715 370,715
+13,000 +13,000
383,715 383,715
06/30/20 06/30/20 +13,000 06/30/20
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 $ 383,715.00
Charles Minor Digitally signed by Charles Minor Date: 2020.02.03 08:23:08 -05'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2020.02.03 12:54:07 -05'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2020.02.03 13:24:48 -05'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2020.02.05 14:33:30 -05'00'
File details come from the government source that posted it. Updated .