CN-370000-GC923-T6.pdf

DEP Contract No. GC923, Attachment C, Page 1 of 4

Attachment C

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

Contract No. GC923 Task No. 6 Amendment No. Date: June 9, 2022 Performance Period: Effective the date of execution of this Task Assignment or July 1, 2022, whichever is later, and shall remain in effect until June 30, 2023.

Description:

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

GC923:

- Conduct routine compliance inspections for storage tank systems at the 430 facilities within Polk and

Hardee Counties, identified in Exhibit #1, by May 31, 2023.

- Conduct additional inspection noted as Complaint Inspection on the Routine Compliance task list to clarify/verify registration at the facilities identified.

- Comply with the Invoice Procedure (Page 2).

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

- Inspection staff to attend annual meeting Spring 2023.

The Enforcement County Contractors must perform all Enforcement Actions in accordance with Guidance Document F (Level of Effort). Guidance Document F available online at:

https://floridadep.gov/waste/permitting-compliance-assistance/documents/f-level-effort-guidance

Contractors are to follow Scope of Work (Attachment A) and appropriate Guidance Documents attached to this Task Assignment via the following links:

Guidance Document A – Storage Tank System Program Violation List https://floridadep.gov/waste/permitting-compliance-assistance/documents/guidance-document-storage-tanks- program-violations

Guidance Document B – Florida Inspections Reporting for Storage Tanks (FIRST) User Requirements https://depedms.dep.state.fl.us/Oculus/servlet/shell?command=getEntity&[guid=11.3384454.1]&[profile=DWM

Guidance Document C1 – Instructions for Conducting Sampling During Aboveground Storage Tank Closure https://www.flrules.org/gateway/reference.asp?No=Ref-11184

Guidance Document C2 – Instructions for Conducting Sampling During Underground Storage Tank Closure https://www.flrules.org/gateway/reference.asp?No=Ref-11183

Guidance Document D1 – Compliance Verification Program Local Review Form https://floridadep.gov/waste/permitting-compliance-assistance/documents/d1-compliance-verification-program-local-program

Guidance Document D2 – Contractual Review Form https://floridadep.gov/waste/permitting-compliance-assistance/documents/d2-contract-review-form

Guidance Document E – Contractual Services Invoice https://floridadep.gov/waste/permitting-compliance-assistance/documents/e-contractual-services-invoice

Guidance Document F – Level of Effort Guidance https://floridadep.gov/waste/permitting-compliance-assistance/documents/f-level-effort-guidance

DEP Contract No. GC923, Attachment C, Page 2 of 4

Guidance Document G – Guidelines for Case Referrals https://floridadep.gov/waste/permitting-compliance-assistance/documents/g-guidance-case-referrals

Guidance Document H – Contractual Service Payment Calculation https://floridadep.gov/waste/permitting-compliance-assistance/documents/h-contractual-service-payment-calculation

Guidance Document H1 – Contractual Service Payment Calculation - Ethanol/Biodiesel Inspections https://floridadep.gov/waste/permitting-compliance-assistance/documents/h1-contractual-service-payment-calculation

Guidance Document I – DEP Directive 923 Settlement Guidelines for Civil and Administrative Penalties https://floridadep.gov/waste/permitting-compliance-assistance/documents/i-dep-directive-923-settlement-guidelines-civil-and

Variable Inspection Approval

Certain “variable” inspections, (compliance assistance – component, compliance assistance – reinspection, and complaint), require pre-approval from the Department. The County/Local Government must send a request via email to STR_Variables@FloridaDEP.gov for approval. The Department will respond with an approval email. The County/Local government must submit a copy of the approval email with the appropriate invoice.

Facility Inspections Swap

If during the task assignment period, a county inspection program determines that an assigned facility should not be inspected for reasons such as the assigned facility has closed, etcetera; then a swap should be requested as soon as possible. The County/Local Government must send a request via email to STR_Swaps@ FloridaDEP.gov for approval. The Department will respond with an approval email that will list a replacement facility.

Invoices

Review of Inspections: The Payment Calculation Sheet (Guidance Document H) shall be submitted no later than the 5th of each month (excluding weekends and state holidays) by the county to DWM NorthStar via STR_Invoices@ FloridaDEP.gov . A separate Guidance Document H1 and supporting FIRST report shall also be submitted for variable compliance inspections done to verify work done by ethanol contractors. NorthStar will review in FIRST each variable inspection listed on the Payment Calculation Sheet to ensure that it is correctly invoiced. NorthStar will ensure that each routine compliance inspection on the Payment Calculation Sheet is also listed on the task assignment facilities list. Upon completion of the review, NorthStar shall report via email to Department’s Contract Manager and the County/Local Government that the review of the inspections has been completed and if any known contractual obligations have not been met.

Invoice Submission: All invoices with the verified and approved Payment Calculation Sheet by the appropriate NorthStar contractor will be directly submitted by the County/Local Governments to the Department’s Contract Manager by the 15th of each month. Submission of invoice shall be via email to: STR_Invoices@ FloridaDEP.gov, copy Roger.Ruiz@FloridaDEP.gov , consisting of a single PDF package.

The order of documents in the complete PDF package:

1) Contractual Services Invoice (Guidance Document E)

2) Verified Payment Calculation Sheet (Guidance Document H) - please make sure the month of services rendered appears below the “Invoice Period”.

3) FIRST Report (Compliance and Activity by Date Range)

4) Tracking Form (Monthly percentage of Routine Inspections Completed)

Payment Schedule:

Compensation will occur on a monthly basis, per the fee schedule listed in Guidance Document H. Invoices are due no later than the 15th day of the month proceeding work activity. The twelfth month invoice will be due to the DEP District Office on the first business day of July. The Contractor must submit a signed ‘Contractual Services Invoice’ (Guidance Document E) noting the quantity and location of inspections.

https://floridadep.gov/waste/permitting-compliance-assistance/documents/g-guidance-case-referrals https://floridadep.gov/waste/permitting-compliance-assistance/documents/h-contractual-service-payment-calculation https://floridadep.gov/waste/permitting-compliance-assistance/documents/h1-contractual-service-payment-calculation https://floridadep.gov/waste/permitting-compliance-assistance/documents/h1-contractual-service-payment-calculation https://floridadep.gov/waste/permitting-compliance-assistance/documents/i-dep-directive-923-settlement-guidelines-civil-and https://floridadep.gov/waste/permitting-compliance-assistance/documents/i-dep-directive-923-settlement-guidelines-civil-and mailto:STR_Variables@FloridaDEP.gov mailto:STR_Swaps@dep.state.fl.us mailto:STR_Invoices@dep.state.fl.us mailto:STR_Invoices@dep.state.fl.us mailto:STR_Invoices@dep.state.fl.us mailto:Roger.Ruiz@FloridaDEP.gov

DEP Contract No. GC923, Attachment C, Page 3 of 4

Required Signatures:

FDEP Contract No:

GC923

Task Assignment No:

Date: DEP Task Manager:

Roger Ruiz

Project: GC923-6 Contractor Name: Polk County Health Department

Contractor Representative:

Ralph Meder

Phone:

863-578-2031

Email:

Ralph.Meder@flhealth.gov

FDEP Contract Manager:

Roger Ruiz

Phone:

850-245-8854

Email:

roger.ruiz@floridadep.gov Task Description:

Conduct routine compliance inspections at the facilities identified in Exhibit #1 (provided electronically). Perform inspections for all reported complaints, discharges, installations and closures involving storage tank systems within the county or counties on Page 1 of this Task Assignment. Conduct additional inspections noted as Complaint Inspections on the Routine Compliance task list to clarify/verify registration information at the facilities identified. Conduct additional inspections noted as Complaint Inspections at facilities requested by the Department to verify completion of work under the Ethanol/Biodiesel Program.

Attend 2022 - 2023 training meeting.

Deliverables:

Submit Contractual Services Invoice with verified Payment Calculation Sheet, along with FIRST Report (Compliance and Activity by Date Range) and Tracking Form (Monthly percentage of Routine Inspections Completed) Compensation will only occur for routine annual compliance inspections conducted at the facilities explicitly identified Exhibit 1 and variable inspections identified in supporting documentation.

Submit travel reimbursement forms, supporting receipts, and agenda for 2022-2023 training.

Performance Measures:

The CONTRACTOR shall complete the following percentage of the required routine compliance inspections unless otherwise indicated in the Task Assignment:

(1) After four (4) months, thirty-three percent (33%) of inspections shall be completed.

(2) After eight (8) months, sixty-six (66%) of inspections shall be completed.

(3) After (12) months, one hundred percent (100%) of inspections shall be completed.

Financial Consequences: 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.

Florida Department of Environmental Protection

TASK ASSIGNMENT FORM

DEP Contract No. GC923, Attachment C, Page 4 of 4

Start Date: 07/01/2022 Completion Date: 06/30/2023

Total Task Value: $ 280,357

Signatures and Date:

Roger Ruiz Contract Manager, FDEP Signature Date

Tameshia Reid Budget Representative, FDEP Signature Date

Ralph Meder Contractor, Contract Manager Signature Date

Teresa Booeshaghi Contract Authority, FDEP Signature Date

Encumbrance Information:

Budget Entity

Project

Grant

Org Code Category & Year

Fund Special Category

Object Code

EO Amount

37450300 GC923 37450104000 00 212001 100029 132500 JD $280,357

Total: $ 280,357

Florida Department of Environmental Protection

TASK ASSIGNMENT FORM

Ralph J. Meder, P.G.

Digitally signed by Ralph J.

Meder, P.G.

Date: 2022.06.10 08:25:48 -04'00' 6/10/2022

Roger Ruiz Digitally signed by Roger Ruiz Date: 2022.06.20 09:27:17 -04'00'

Tameshia N. Reid Digitally signed by Tameshia N.

Reid Date: 2022.06.20 10:19:45 -04'00'

Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2022.06.20 10:51:56 -04'00'