CN-370000-GC923-T6CO3.pdf
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- Contract number
- GC923
- Issued by
- Florida
About this file
Task Assignment Change Order Summary
This is a Task Assignment Change Order Form (Change Order No. 3) issued by the Florida Department of Environmental Protection (DEP) for contract GC923-6 with Polk County. The change order was executed on June 6, 2023, with the contractor represented by Ralph Meder and DEP Contract Manager Roger Ruiz overseeing the modification.
The change order reduces the scope of routine compliance inspections for storage tank systems from 430 to 88 inspections due to personnel issues affecting Polk County operations. This reduction results in a net decrease of $186,390 to the task amount, bringing the total task cost from $280,357 to $93,967. The original completion date of May 31, 2023, has been extended to June 30, 2023. The funding modification affects budget entity 37450300 with Special Category 100029, reducing the year 00 appropriation by $186,390. The change order was approved by Budget Representative Tameshia N. Reid and Contractual Authority Teresa Booeshaghi on June 7, 2023.
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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:
GC923-6 06/06/2023 3
POLK COUNTY
Ralph Meder
Roger Ruiz
Reduction of 342 Routine Compliance Inspections, from 430 to 88 Routine Compliance Inspections due to personnel issues from GC923-6 Polk County.
A net decrease of $186,390.
This change revises the sentence in Task Assignment #6 for DEP Contract GC923 reading:
"Conduct routine compliance inspections for storage tank systems at the 88 facilities within Polk and Hardee Counties, identified in Exhibit #1, by May 31, 2023.", to read:
"Conduct routine compliance inspections for storage tank systems at the 88 facilities within Polk and Hardee Counties, identified in Exhibit #1, by June 30, 2023."
280,357 280,357
280,357 280,357
-186,390 -186,390
93,967 93,967
06/30/23 06/30/23 -186,390 06/30/23
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 $ 280,357.00
37450104000 JD 132500 37450300 100029 00 -$ 186,390.00
Ralph J. Meder, P.G.
Digitally signed by Ralph J. Meder, P.G.
Date: 2023.06.06 14:44:49 -04'00'
06/06/2023 Roger Ruiz Digitally signed by Roger Ruiz Date: 2023.06.07 07:47:03 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2023.06.07 09:40:11 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2023.06.07 09:50:36 -04'00'
File details come from the government source that posted it. Updated .