CN-370000-GC923-T8CO3.pdf
PDF 128 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 22, 2025, for Polk County. The contractor is represented by Ralph Meder as the Contractor Representative, with Roger Ruiz serving as the FDEP Contract Manager. The change order was approved by Budget Representative Tameshia N. Reid and Contractual Authority John J Truitt on April 28-29, 2025.
The change order reflects a net decrease in task assignment funding of $31,680, reducing the total task amount from $467,874.46 to $436,194.46. The funding adjustment is documented with accounting codes (Organization Code 37450104000, E.O. JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, Year 00) and includes corresponding line items showing both the original amount of $467,874.46 and the reduction of $31,680.00. The task completion date remains unchanged at June 30, 2025. The change order has been distributed to the Procurement Section (MS93) and the Bureau of Finance & Accounting (MS78) for processing.
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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 04/22/2025 3
POLK COUNTY
Ralph Meder
Roger Ruiz
Decrease in funds for Task Assignment of $31,680.
A net decrease of $31,680.
467,874.46 467,874.46
467,874.46 467,874.46
-31,680 -31,680
436,194.46 436,194.46
06/30/25 06/30/25 -31,680 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
37450104000 JD 132500 37450300 100029 00 $ 467,874.46
37450104000 JD 132500 37450300 100029 00 -$ 31,680.00
Ralph J. Meder, P.G.
Digitally signed by Ralph J. Meder, P.G.
Date: 2025.04.28 14:35:01 -04'00'
04/28/2025 Roger Ruiz Digitally signed by Roger Ruiz Date: 2025.04.28 14:40:08 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2025.04.28 15:37:38 -04'00'
John J Truitt Digitally signed by John J Truitt Date: 2025.04.29 08:51:09 -04'00'
04/29/2025
File details come from the government source that posted it. Updated .