CN-370000-GC925-T3CO1.pdf
PDF 1 MB 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 January 29, 2020. The document modifies an existing task assignment (GC925-3) with Orange County. The contractor is represented by David Jones, and the DEP Contract Manager is Roger Ruiz. The change order has been approved by Griffin Kolchakian (Budget Representative) and Teresa Booeshaghi (Contractual Authority), with all signatures digitally executed on January 30 and February 5, 2020.
The change order increases funding for Variable Inspections by $32,000, raising the total task amount from $792,674 to $824,674. The task completion date remains June 30, 2020, with no extension to the original timeline. The funding is allocated through Organizational Code 37450104000 with E.O. designation JD, Object Code 132500, Budget Entity 37450300, and Special Category 100029. The total amended contract value is $824,674.00. Copies of this change order have been distributed to the Procurement Section (MS93) and two copies to the Bureau of Finance & Accounting (MS78).
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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:
GC925-3 01/29/2020 1
ORANGE COUNTY
David Jones
Roger Ruiz
Increase in funds for Variable Inspections for $32,000.
792,674 792,674
792,674 792,674
+32,000 +32,000
824,674 824,674
06/30/20 06/30/20 +32,000 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 $ 824,674.00
David D. Jones Digitally signed by David D. Jones Date: 2020.01.30 06:51:17 -05'00' 01/30/2020 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2020.01.30 07:40:14 -05'00'
Griffin Kolchakian Digitally signed by Griffin Kolchakian Date: 2020.01.30 09:50:36 -05'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2020.02.05 14:34:29 -05'00'
File details come from the government source that posted it. Updated .