CN-370000-GC925-T1CO3.pdf
PDF 656 KB Posted
- Contract number
- GC925
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection on May 31, 2018. The document pertains to a task assignment with Orange County, represented by David Jones as the contractor representative, with Roger Ruiz serving as the DEP Contract Manager. The change order is identified as Change Order No. 3 under Task Assignment Number GC925-1.
The change order reflects a reduction of 12 routine inspections, decreasing the total assigned inspections from 1,237 to 1,225. This reduction results in a net decrease of $6,186.00 to the task amount. The original task amount was $801,833.30, which prior to this change order had been increased to $809,845.35. Following this change order, the task amount with all change orders is $803,659.35. The task completion date remains June 30, 2018, with no adjustment to the timeline. The funding is allocated from Org. Code 37450104000 under E.O. JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, for fiscal year 2018, with the total budgeted amount of $803,659.35. The change order was approved on June 6, 2018, by Contract Manager Roger Ruiz, Budget Representative Jennifer Vickers, and Contractual Authority Tim J. Bahr.
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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 05/31/2018 3
ORANGE COUNTY
David Jones
Roger Ruiz
Reduction of 12 Routine Inspections, from 1237 Routine Inspections assigned, to 1225 Routine Inspections.
A net decrease of $6,186.00.
801,833.30 801,833.30
809,845.35 809,845.35
(6,186.00) (6,186.00)
803,659.35 803,659.35
06/30/18 06/30/18 (6,186.00) 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 $ 803,659.35
Roger Ruiz Digitally signed by Roger Ruiz Date: 2018.06.06 12:40:56 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.06.06 14:23:48 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.06.06 17:18:06 -04'00' dweatherford Approved
File details come from the government source that posted it. Updated .