CN-370000-GC924-T2CO5.pdf
PDF 654 KB Posted
- Contract number
- GC924
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) on June 11, 2019. The document modifies an existing task assignment with Gulf County, represented by contractor Sarah Hinds, with Roger Ruiz serving as the FDEP Contract Manager. The change order is designated as Change Order No. 5 under Task Assignment Number GC924-2.
The change order increases the task amount by $6,000.00 specifically for variable inspections. The original task amount was $62,935.00, which had previously been increased to $67,135.00 prior to this change order. With this modification, the total task amount with all change orders is now $73,135.00. The completion date remains unchanged at June 30, 2019. The funding is allocated from budget entity 37450300, with object code 132500, special category 104138, and organizational code 37450104000, totaling $73,135.00. The change order was approved by Griffin Kolchakian (Budget Representative) and Teresa Booeshaghi (Contractual Authority), with copies distributed to the Procurement Section and Bureau of Finance & Accounting.
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Other files
| File | Type | Posted |
|---|---|---|
| CN-370000-GC924-A2.pdf.crdownload | CRDOWNLOAD file | |
| CN-370000-GC924-T1.pdf | ||
| CN-370000-GC924-T1CO2.pdf | ||
| CN-370000-GC924-T3CO2.pdf | ||
| CN-370000-GC924-A2.pdf | ||
| CN-370000-GC924-T2.pdf | ||
| CN-370000-GC924-T2CO1.pdf | ||
| CN-370000-GC924-T2CO2.pdf | ||
| CN-370000-GC924-T2CO3.pdf | ||
| CN-370000-GC924-T6.pdf | ||
| CN-370000-GC924-T7.pdf | ||
| CN-370000-GC904-CMC3.pdf | ||
| CN-370000-GC924-ARC1.pdf | ||
| CN-370000-GC924-T1CO1.pdf | ||
| CN-370000-GC924-T3.pdf | ||
| CN-370000-GC924-T3CO1.pdf | ||
| CN-370000-GC924-T4.pdf | ||
| CN-370000-GC924-T5.pdf | ||
| CN-370000-GC924-T5CO1.pdf | ||
| CN-370000-GC924-T7CO1.pdf | ||
| CN-370000-GC924-T7CO2.pdf | ||
| CN-370000-GC924-T9.pdf | ||
| CN-370000-GC924-A3.pdf | ||
| CN-370000-GC924-T2CO4.pdf | ||
| CN-370000-GC924-T8.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 .