CN-370000-GC924-T2CO5.pdf
PDF 654 KB Posted
- Contract number
- PL523
- Issued by
- Florida
About this file
This document is a Task Assignment Change Order Form from the Florida Department of Environmental Protection, involving Gulf County as the contractor. The change order is associated with task assignment GC924-2, dated 06/11/2019, and specifically involves the contract between the Florida Department of Environmental Protection and Gulf County, with Roger Ruiz serving as the DEP Contract Manager and Sarah Hinds representing Gulf County.
The change order increases the task funds by $6,000.00 for Variable Inspections, bringing the total task amount from $67,135.00 to $73,135.00. The original task completion date remains 06/30/19, with no change to the project timeline. The funding information includes an organizational code of 374501040000, an object code of 132500, a budget entity of 37450300, and a special category of 104138. The change order maintains the same completion date and does not alter the fundamental scope of the original task assignment.
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Other files
| File | Type | Posted |
|---|---|---|
| CN-370000-PL523-T8.pdf | ||
| CN-370000-PL523-T5.pdf | ||
| CN-370000-PL523.pdf | ||
| CN-370000-PL523-T1.pdf | ||
| CN-370000-PL523-T2.pdf | ||
| CN-370000-PL523-T3.pdf | ||
| CN-370000-PL523-T4.pdf | ||
| ContractBudgetExport.csv | CSV file | |
| CN-370000-PL523-T6.pdf | ||
| CN-370000-PL523-T7.pdf |
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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:
GC924-2 06/11/2019 5
GULF COUNTY
Sarah Hinds
Roger Ruiz
Increase in Funds for Variable Inspections in the amount of $6,000.00
62,935.00 62,935.00
67,135.00 67,135.00
+6,000.00 +6,000.00
73,135.00 73,135.00
06/30/19 06/30/19 +6,000.00 06/30/19
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 104138 00 $ 73,135.00
Sarah Hinds Digitally signed by Sarah Hinds DN: cn=Sarah Hinds, o=Gulf County, ou=Florida Department of Health, email=Sarah.Hinds@flhealth.gov, c=US Date: 2019.06.11 14:26:04 -04'00'
Roger Ruiz Digitally signed by Roger Ruiz Date: 2019.06.11 14:30:50 -04'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2019.06.11 15:46:29 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2019.06.11 16:41:34 -04'00'
File details come from the government source that posted it. Updated .