CN-370000-GC924-T3CO1.pdf
PDF 1008 KB Posted
- Contract number
- GC924
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection dated January 29, 2020. The document modifies an existing task assignment with Gulf County, with Sarah Hinds serving as the contractor representative and Roger Ruiz as the DEP Contract Manager. The change order was approved by Griffin Kolchakian (Budget Representative) and Teresa Booeshaghi (Contractual Authority).
The change order increases the task assignment funding by $600 specifically allocated for travel allotment expenses. The original task amount of $63,797 is increased to $64,397, with no modification to the task completion date of June 30, 2020. The funding is charged to Organizational Code 37450104000, using E.O. JD and Object Code 132500, with Budget Entity 37450300, Special Category 100029, and Year 00. The total modified contract amount is $64,397.00, and the document was distributed to the Procurement Section (MS93) and Bureau of Finance & Accounting (MS78).
View the file
Other files
| File | Type | Posted |
|---|---|---|
| CN-370000-GC904-CMC3.pdf | ||
| CN-370000-GC924-ARC1.pdf | ||
| CN-370000-GC924-T1CO1.pdf | ||
| CN-370000-GC924-T3.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-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-GC924-A3.pdf | ||
| CN-370000-GC924-T2CO4.pdf | ||
| CN-370000-GC924-T8.pdf | ||
| CN-370000-GC924-A2.pdf.crdownload | CRDOWNLOAD file | |
| CN-370000-GC924-T1.pdf | ||
| CN-370000-GC924-T1CO2.pdf | ||
| CN-370000-GC924-T2CO5.pdf | ||
| CN-370000-GC924-T3CO2.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:
GC924-3 01/29/2020 1
GULF COUNTY
Sarah Hinds
Roger Ruiz
Increase in funds for Travel Allotment for $600.
63,797 63,797
63,797 63,797
+600 +600
64,397 64,397
06/30/20 06/30/20 +600 06/30/20
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 $ 64,397.00
Digitally signed by Sarah Hinds DN: C=US, O=Florida Department of Health, CN=Sarah Hinds, E=Sarah.Hinds@flhealth.gov Reason: I am the author of this document Location: your signing location here Date: 2020-02-05 15:35:40 Foxit Reader Version: 9.6.0
Sarah Hinds Roger Ruiz Digitally signed by Roger Ruiz Date: 2020.02.10 10:03:01 -05'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2020.02.10 13:31:34 -05'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2020.02.10 13:48:50 -05'00'
File details come from the government source that posted it. Updated .