CN-370000-GC924-T1CO2.pdf

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Attached to
Master Agreement FL|GC924|c560f091e904e082a29e787f42919918
Contract number
GC924
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 May 2, 2018. The change order modifies task assignment GC924-1 with Gulf County, with Marsha P. Lindeman serving as the contractor representative and Roger Ruiz as the FDEP Contract Manager. The document has been approved by Jennifer Vickers (Budget Representative) and F. Joseph Jr. Ullo (Contractual Authority).

The change order implements a reduction in funding for Variable Inspections, resulting in a net decrease of $5,000.00 to the task assignment. The task amount prior to this change order was $67,432.56, which is reduced to $62,432.56 with all change orders applied. The original task completion date of June 30, 2018 remains unchanged. Funding for the modified task amount is allocated from Org. Code 37450104000, E.O. JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, for fiscal year 2018, totaling $62,432.56. The change order has been distributed to the Procurement Section and the 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:

GC924-1 05/02/2018 2

GULF COUNTY

Marsha P. Lindeman

Roger Ruiz

Reduction on funding for Variable Inspections.

A net decrease of $5,000.00.

66,765.42 66,765.42

67,432.56 67,432.56

(5,000.00) (5,000.00)

62,432.56 62,432.56

06/30/18 06/30/18 (5,000.00) 06/30/18

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 2018 $ 62,432.56

Marsha P.

Lindeman

Digitally signed by Marsha P.

Lindeman Date: 2018.05.02 13:25:25 -04'00'

05/02/2018 Roger Ruiz Digitally signed by Roger Ruiz Date: 2018.05.02 14:57:10 -04'00'

Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.05.02 15:53:34 -04'00'

Digitally signed by F. Joseph Jr.

Ullo Date: 2018.05.09 07:48:19 -04'00'

File details come from the government source that posted it. Updated .