CN-370000-GC925-T3CO4.pdf
PDF 655 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 June 1, 2020. The change order modifies an existing task assignment numbered GC925-3 with Orange County. The contractor representative is David Jones, and the DEP Contract Manager is Roger Ruiz.
The change order increases funding for Variable Inspections by $10,000, resulting in a net increase to the task amount. The original task amount was $792,674, which had been reduced to $728,275.50 prior to this change order. With the $10,000 increase, the total task amount with all change orders is now $738,275.50. The task completion date remains June 30, 2020 with no time extensions. The funding is allocated through organizational code 37450104000 under E.O. JD, object code 132500, budget entity 37450300, special category 100029, and year 00. The change order was approved by the Budget Representative (Monica J. Brady) and Contractual Authority (Teresa Booeshaghi) on June 1, 2020, and will be distributed to the Procurement Section and Bureau of Finance & Accounting.
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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 06/01/2020 4
ORANGE COUNTY
David Jones
Roger Ruiz
Increase in funds for Variable Inspections for $10,000.
A net increase of $10,000.
792,674 792,674
728,275.50 728,275.50
+ 10,000 + 10,000
738,275.50 738,275.50
06/30/20 06/30/20 + 10,000 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 $ 738,275.50
Renée H Parker Digitally signed by Renée H Parker Date: 2020.06.01 14:04:22 -04'00' 06/01/2020 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2020.06.01 14:56:20 -04'00'
Monica J. Brady Digitally signed by Monica J.
Brady Date: 2020.06.01 15:35:33 -04'00'
06/01/2020
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2020.06.01 15:50:55 -04'00'
06/01/2020
File details come from the government source that posted it. Updated .