CN-370000-GC923-T5CO4.pdf
PDF 654 KB Posted
- Contract number
- GC923
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 4) issued by the Florida Department of Environmental Protection on May 25, 2022. The document pertains to a task assignment (GC923-5) with Polk County as the contractor, with Ralph Meder serving as the contractor representative and Roger Ruiz as the DEP Contract Manager.
The change order reduces the scope of routine compliance inspections from 430 inspections to 303 inspections, representing a reduction of 127 inspections due to personnel issues. This scope reduction results in a net decrease of $65,468.50 to the task amount. The original task amount of $267,672 is reduced to $202,203.50 following this change order. The task completion date remains June 30, 2022. Funding for the revised amount of $202,203.50 is allocated from Org. Code 37450104000 under E.O. JD, Object Code 132500, Budget Entity 37450300, and Special Category 100029. The change order was approved by all required parties, including the contract manager, budget representative, and contractual authority.
View the file
Other files
Show all 39
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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:
GC923-5 05/25/2022 4
POLK COUNTY
Ralph Meder
Roger Ruiz
Reduction of 127 Routine Compliance Inspections, from 430 Routine Compliance Inspections assigned, to 303 Routine Compliance Inspections due to personnel issues.
A net decrease of $65,468.50.
267,672 267,672
267,672 267,672
- 65,468.50 - 65,468.50
202,203.50 202,203.50
06/30/22 06/30/22
- 65,468.50 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 $ 202,203.50
Ralph J. Meder, P.G.
Digitally signed by Ralph J. Meder, P.G.
Date: 2022.05.25 10:10:25 -04'00'
05/25/2022 Roger Ruiz Digitally signed by Roger Ruiz Date: 2022.05.25 10:22:02 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.05.25 11:18:29 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2022.05.25 11:27:46 -04'00'
File details come from the government source that posted it. Updated .