CN-370000-GC925-T4CO1.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 June 9, 2021. The form documents a contractual modification for Task Assignment Number GC925-4 involving Orange County, with David Jones serving as the Contractor Representative and Roger Ruiz as the DEP Contract Manager. The change order has been approved by Monica J. Brady (Budget Representative) and Teresa Booeshaghi (Contractual Authority).
The change order reduces the scope of routine compliance inspections from 1,100 to 1,088 inspections per request from GC925-4 Orange, resulting in a net decrease of $6,186.00 in task amount. The original task amount of $754,050 is reduced to $747,864 following this modification. The task completion date remains June 30, 2021, with no change in the contract timeline. Funding for the revised amount of $747,864.00 is allocated from Org. Code 37450104000, E.O. JD, Object Code 132500, Budget Entity 37450300, and Special Category 100029. The change order was executed on June 10, 2021, and copies have been distributed to the Procurement Section (MS93) and 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:
GC925-4 06/09/2021 1
ORANGE COUNTY
David Jones
Roger Ruiz
Reduction of 12 Routine Compliance Inspections, from 1100 to 1088 Routine Compliance Inspections per request from GC925-4 Orange.
A net decrease of $6,186.00.
754,050 754,050
754,050 754,050
- 6,186 - 6,186
747,864 747,864
06/30/21 06/30/21
- 6,186 06/30/21
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 $ 747,864.00
David D. Jones Digitally signed by David D. Jones Date: 2021.06.10 07:36:08 -04'00' 06/10/2021 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2021.06.10 08:28:33 -04'00'
Monica J. Brady Digitally signed by Monica J.
Brady Date: 2021.06.10 12:21:45 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2021.06.10 14:06:39 -04'00'
File details come from the government source that posted it. Updated .