CN-370000-GC925-T1CO6.pdf
PDF 655 KB Posted
- Contract number
- GC925
- Issued by
- Florida
About this file
Task Assignment Change Order Summary
This is a Task Assignment Change Order Form (Change Order No. 6) issued by the Florida Department of Environmental Protection (FDEP) on June 28, 2018, for work performed by Orange County. The document reflects modifications to an existing task assignment identified as GC925-1 and involves FDEP Contract Manager Roger Ruiz and Contractor Representative David Jones. The change order was approved by Budget Representative Jennifer Vickers and Contractual Authority Tim J. Bahr.
The change order authorizes a net increase of $6,000.00 to the task amount for variable inspections, bringing the total task amount with all change orders from $841,757.96 to $847,757.96. The fee schedule component reflects this same $6,000.00 increase. The original task completion date of June 30, 2018, remains unchanged, with no modification to the task period. The funding is charged to Organizational Code 37450104000 under Object Code 132500 with Budget Entity 37450300 and Special Category 100029 for fiscal year 2018, resulting in a total budgeted amount of $847,757.96.
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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 06/28/2018 6
ORANGE COUNTY
David Jones
Roger Ruiz
Increase in Task Amount for Variable Inspections.
A net increase of $6,000.00
801,833.30 801,833.30
841,757.96 841,757.96
6,000.00 6,000.00
847,757.96 847,757.96
06/30/18 06/30/18 18,400.00 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 $ 847,757.96
David D. Jones Digitally signed by David D. Jones Date: 2018.06.28 16:00:54 -04'00' 06/28/2018 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2018.06.28 16:06:26 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.06.28 16:50:48 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.06.29 08:12:11 -04'00'
File details come from the government source that posted it. Updated .