CN-370000-GC925-T1CO1.pdf
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- Contract number
- GC925
- Issued by
- Florida
About this file
Task Assignment Change Order Summary
This document is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection (FDEP) on August 2, 2017, for Task Assignment Number GC925-1 with Orange County. The change order was approved by the FDEP Contract Manager Roger Ruiz, with Budget Representative Jennifer Vickers and Contractual Authority John Truitt providing final approval on August 9 and 11, 2017, respectively.
The change order modifies the routine inspection pricing structure, increasing the per-inspection rate from $510.40 to $515.50, representing a net increase of $5.10 per routine inspection. This price adjustment became effective September 1, 2017, with all inspections conducted through August 31, 2017, paid at the original rate of $510.40. The modification increased the total task amount by $8,012.04, raising the contract value from $801,833.30 to $809,845.34. The task completion date remained unchanged at June 30, 2018. Funding was allocated from Org. Code 37450104000 under Object Code 132500 (Special Category 100029) in the amount of $809,845.34.
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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:
GC925-1 08/02/2017 1
ORANGE COUNTY
David Jones
Roger Ruiz
Amount increase per Routine Inspection from $510.40 to $515.50.
A net increase of $5.10 per Routine Inspection.
The increase will become effective September 1, 2017. All inspections conducted through August 31, 2017, will be paid at the rate of $510.40.
801,833.30 801,833.30
801,833.30 801,833.30
8,012.04 8,012.04
809,845.35 809,845.34
06/30/18 06/30/18 $8,012.04 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 00 $ 809,845.34
08/09/2017 Roger Ruiz Digitally signed by Roger Ruiz Date: 2017.08.09 08:41:29 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2017.08.09 10:51:50 -04'00'
08/09/2017
John Truitt Digitally signed by John Truitt Date: 2017.08.11 14:59:15 -04'00' djones1 Approved
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