CN-370000-GC923-T8CO4.pdf
PDF 310 KB Posted
- Contract number
- GC923
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 4) issued by the Florida Department of Environmental Protection (FDEP) on May 20, 2025. The document modifies an existing contract (GC923) with Polk County, represented by Ralph Meder as the contractor representative. The change order was approved by FDEP Contract Manager Roger Ruiz, Budget Representative Tameshia N. Reid, and Contractual Authority John J Truitt.
The change order modifies Task Assignment #8 under DEP Contract GC923 to reduce the scope of routine compliance inspections for storage tank systems due to personnel issues. The original task required Polk County to conduct routine compliance inspections at 564 facilities within Polk and Hardee Counties by May 31, 2025. The revised task reduces this to 141 facilities (25% of original scope) with an extended completion date of June 30, 2025. The financial impact reflects a net decrease in task amount of $31,680, reducing the total task amount from $467,874.46 to $436,194.46. The funding is allocated from Org. Code 37450104000, Object Code 132500, Budget Entity 37450300, and Special Category 100029, with no change to the completion date of June 30, 2025 after all change orders are applied.
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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 05/20/2025 4
POLK COUNTY
Ralph Meder
Roger Ruiz
Performance Measures:
Due to personnel issues, for Invoice 12, GC923-8 Polk County, shall complete (25%) or 141 Routine Compliance Inspections.
This change revises the sentence in Task Assignment #8 for DEP Contract GC923 reading:
"Conduct routine compliance inspections for storage tank systems at the 564 facilities within Polk and Hardee Counties, identified in Exhibit #1, by May 31, 2025.", to read:
"Conduct routine compliance inspections for storage tank systems at the 141 facilities within Polk and Hardee Counties, identified in Exhibit #1, by June 30, 2025."
467,874.46 467,874.46
436,194.46 436,194.46
-31,680
436,194.46 436,194.46
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
37450104000 JD 132500 37450300 100029 00 $ 467,874.46
37450104000 JD 132500 37450300 100029 00 -$ 31,680.00
Ralph J Meder, P.G., CPG
Digitally signed by Ralph J Meder, P.G., CPG
Date: 2025.05.20 10:31:34 -04'00'
05/20/2025 Roger Ruiz Digitally signed by Roger Ruiz Date: 2025.05.20 10:48:13 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2025.05.21 08:36:44 -04'00'
John J Truitt Digitally signed by John J Truitt Date: 2025.05.21 11:03:44 -04'00'
File details come from the government source that posted it. Updated .