CN-370000-GC923-T8CO1.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 (OOO-012) issued by the Florida Department of Environmental Protection (FDEP) on October 8, 2024. The change order modifies Task Assignment GC923-8 between the FDEP and Polk County. The document was signed by Ralph J. Meder, P.G. (Contractor Representative) on October 16, 2024, Roger Ruiz (DEP Contract Manager) on October 16, 2024, Tameshia N. Reid (Budget Representative) on October 17, 2024, and Jessica Kramer (Contractual Authority) on October 28, 2024.
The change order addresses performance measures for the Polk County task assignment due to personnel issues. The contractor shall complete 4 percent, or 23 Routine Compliance Inspections, within the first four months of performance. The original task amount and task amount with all change orders remain $467,874.46 with no net increase or decrease. The task completion date is 06/30/25 for both the original assignment and after this change order. Funding is provided through Org. Code 37450100000, Object Code 132500, Budget Entity 37450300, Special Category 100029, and Year 00, with the full amount of $467,874.46 allocated to this task.
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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:
GC923-8 10/08/2024 1
POLK COUNTY
Ralph Meder
Roger Ruiz
Performance Measures:
Due to personnel issues, GC923-8 Polk County, for the first Performance Measures, after (4) four months shall complete (4%) or 23 Routine Compliance Inspections.
467,874.46 467,874.46
06/30/25 06/30/25
06/30/25
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
37450100000 JD 132500 37450300 100029 00 $ 467,874.46
Ralph J. Meder, P.G.
Digitally signed by Ralph J. Meder, P.G.
Date: 2024.10.16 13:13:00 -04'00'
10/16/2024 Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.10.16 13:55:07 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.10.17 10:37:18 -04'00'
Jessica Kramer Digitally signed by Jessica Kramer Date: 2024.10.28 16:01:31 -04'00'
File details come from the government source that posted it. Updated .