CN-370000-GC922-TA3CO2.pdf
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- Contract number
- HW684
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 2) issued by the Florida Department of Environmental Protection (FDEP) for Pinellas County. The document is dated January 31, 2019, and involves a task assignment numbered GC922-3. Charles Minor represents the contractor, while Roger Ruiz serves as the FDEP Contract Manager. The change order was approved by Jennifer Vickers (Budget Representative) and Tim J. Bahr (Contractual Authority) on February 1, 2019.
The change order increases funds for variable inspections by $34,000.00, raising the total task amount from $352,450.00 to $386,450.00. The original task completion date of June 30, 2019, remains unchanged. Funding is allocated across two budget line items: $352,450.00 under Object Code 132500 with Special Category 100029, and $34,000.00 under Object Code 132500 with Special Category 104138. Both line items are charged to organization code 37450104000, budget entity 37450300, and year code 00. The change order was distributed to the Procurement Section (MS93) and the 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:
GC922-3 01/31/2019 2
PINELLAS COUNTY
Charles Minor
Roger Ruiz
Increase of Funds for Variable Inspections in the amount of $34,000.00
352,450.00 352,450.00
352,450.00 352,450.00
+34,000.00 +34,000.00
386,450.00 386,450.00
06/30/19 06/30/19 +34,000.00 06/30/19
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 $ 352,450.00
37450104000 JN 132500 37450300 104138 00 $ 34,000.00
$ 386,450.00
Charles Minor Digitally signed by Charles Minor Date: 2019.01.31 11:26:48 -05'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2019.01.31 12:13:10 -05'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2019.02.01 11:36:48 -05'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2019.02.01 13:52:45 -05'00'
File details come from the government source that posted it. Updated .