CN-370000-GC923-T8CO2.pdf
PDF 306 KB Posted
- Contract number
- GC923
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 2) issued by the Florida Department of Environmental Protection (FDEP) dated February 5, 2025. The change order modifies Task Assignment GC923-8 for Polk County, with Ralph Meder serving as the contractor representative and Roger Ruiz as the DEP Contract Manager. The document has been approved by Tameshia N. Reid (Budget Representative) and Jason Andreotta (Contractual Authority).
The change order addresses performance measure adjustments due to personnel issues for the second performance measurement period. Under this modification, Polk County is required to complete 63 Routine Compliance Inspections (representing 11% of total inspections) within eight months. The original task amount and all financial terms remain unchanged at $467,874.46, with no net increase or decrease in task amount. The task completion date remains June 30, 2025. Funding is allocated from Organizational Code 37450100000 under Object Code 132500, Budget Entity 37450300, with Special Category 100029, for a total amount of $467,874.46.
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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 02/05/2025 2
POLK COUNTY
Ralph Meder
Roger Ruiz
Performance Measures:
Due to personnel issues, GC923-8 Polk County, for the second Performance Measures, after (8) eight months shall complete (11%) or 63 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., CPG
Digitally signed by Ralph J Meder, P.G., CPG
Date: 2025.02.05 10:21:52 -05'00' Roger Ruiz
Digitally signed by Roger Ruiz Date: 2025.02.05 13:20:33 -05'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2025.02.05 14:18:20 -05'00'
Jason Andreotta Digitally signed by Jason Andreotta Date: 2025.02.06 13:45:33 -05'00'
File details come from the government source that posted it. Updated .