CN-370000-GC923-T7CO1.pdf
PDF 655 KB Posted
- Contract number
- GC923
- 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) on October 9, 2023, for Task Assignment Number GC923-7 with Polk County. The contractor representative is Ralph Meder, and the FDEP Contract Manager is Roger Ruiz. The change order was approved by Tameshia N. Reid (Budget Representative) and Teresa Booeshaghi (Contractual Authority) on October 10, 2023.
The change order addresses performance measure adjustments due to personnel issues affecting GC923-7 in Polk County. Specifically, the first performance measurement period has been modified to allow completion of 7% (or 24 Routine Compliance Inspections) within four months, rather than the original schedule. The task amount remains unchanged at $282,789.46, with no net increase or decrease in the financial obligation. The original task completion date and completion date with all change orders remain June 30, 2023. Funding is allocated from Org. Code 37450104000 under E.O. JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, with the full amount of $282,789.46 charged to Year 00.
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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:
GC923-7 10/09/2023 1
POLK COUNTY
Ralph Meder
Roger Ruiz
Performance Measures:
Due to personnel issues, GC923-7 Polk County, for the first Performance Measures, after (4) four months shall complete (7%) or 24 Routine Compliance Inspections.
282,789.46 282,789.46
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 $ 282,789.46
Ralph J. Meder, P.G.
Digitally signed by Ralph J. Meder, P.G.
Date: 2023.10.10 08:49:25 -04'00'
10/10/2023 Roger Ruiz Digitally signed by Roger Ruiz Date: 2023.10.10 09:46:06 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2023.10.10 11:33:03 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2023.10.10 11:44:49 -04'00'
File details come from the government source that posted it. Updated .