CN-370000-GC923-T7CO3.pdf
PDF 656 KB Posted
- Contract number
- GC923
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 3) issued by the Florida Department of Environmental Protection (FDEP) on April 9, 2024, for Task Assignment GC923-7 with Polk County. The contract is managed by FDEP Contract Manager Roger Ruiz, with Polk County represented by Ralph Meder. The change order modifies the scope of work for routine compliance inspections of storage tank systems across 339 facilities located in Polk and Hardee Counties.
The primary modification extends the task completion deadline from May 31, 2024, to June 30, 2024. Concurrent with this timeline extension, the change order reduces the task assignment funding by $139,287.14, bringing the task amount from $235,287.14 to $96,000 with all change orders applied. The original task amount was $282,789.46. Funding for this contract is allocated from budget entity 37450300 (Special Category 100029) under Org. Code 37450104000 with Object Code 132500. The change order has been approved by the Budget Representative (Tameshia N. Reid) and Contractual Authority (Tim Bahr) and is directed to be distributed to the Procurement Section and Bureau of Finance & Accounting.
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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 04/09/2024 3
POLK COUNTY
Ralph Meder
Roger Ruiz
Decrease in funds for Task Assignment of $139,287.14.
A net decrease of $139,287.14.
This change revises the sentence in Task Assignment #7 for DEP Contract GC923 reading:
"Conduct routine compliance inspections for storage tank systems at the 339 facilities within Polk and Hardee Counties, identified in Exhibit #1, by May 31, 2024.", to read:
"Conduct routine compliance inspections for storage tank systems at the 339 facilities within Polk and Hardee Counties, identified in Exhibit #1, by June 30, 2024."
282,789.46 282,789.46
235,287.14 235,287.14
-139,287.14 -139,287.14
96,000 96,000
06/30/24 06/30/24 -139,287.14 06/30/24
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
37450104000 JD 132500 37450300 100029 00 $ 139,287.14
Ralph J. Meder, P.G.
Digitally signed by Ralph J. Meder, P.G.
Date: 2024.04.09 14:11:52 -04'00'
04/09/2024 Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.04.09 14:23:26 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.04.09 15:14:38 -04'00'
Tim Bahr Digitally signed by Tim Bahr Date: 2024.04.09 15:56:59 -04'00'
File details come from the government source that posted it. Updated .