CN-370000-GC922-T7CO1.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 (FDEP) for Task Assignment GC922-7 with Pinellas County. The change order was executed on May 24, 2022, and is identified as Change Order No. 1. The contractor representative is Charles Minor, REHS, and the FDEP contract manager is Roger Ruiz.
The change order extends the completion deadline for routine compliance inspections of storage tank systems from May 31, 2022, to June 30, 2022. The task involves conducting inspections at 530 facilities located within Pinellas and Pasco Counties as identified in Exhibit #1. The contract amount remains unchanged at $376,315.00, funded through Organizational Code 37450104000 with Budget Entity 37450300, Special Category 100029, and Object Code 132500. All required approvals were obtained, including signatures from the contractor, FDEP contract manager, budget representative (Tameshia N. Reid), and contractual authority (John Truitt).
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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:
GC922-7 05/24/2022 1
PINELLAS COUNTY
Charles Minor, REHS
Roger Ruiz
This change revises the sentence in Task Assignment #7 for DEP Contract GC922 reading:
"Conduct routine compliance inspections for storage tank systems at the 530 facilities within Pinellas and Pasco Counties, identified in Exhibit #1, by May 31, 2022.", to read:
"Conduct routine compliance inspections for storage tank systems at the 530 facilities within Pinellas and Pasco Counties, identified in Exhibit #1, by June 30, 2022."
376,315 376,315
06/30/22 06/30/22
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 $ 376,315.00
Charles Minor Digitally signed by Charles Minor DN: cn=Charles Minor, o=Division of Disease Control and Health Protection, ou=Florida Department of Health
- Pinellas, email=Charles.Minor@FLhealth.gov, c=US Date: 2022.05.24 09:43:56 -04'00'
05/24/2022 Roger Ruiz Digitally signed by Roger Ruiz Date: 2022.05.24 10:13:34 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.05.24 10:30:26 -04'00'
John Truitt Digitally signed by John Truitt Date: 2022.05.24 13:11:28 -04'00'
05/24/2022
File details come from the government source that posted it. Updated .