CN-370000-GC925-T5CO1.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 for Orange County. The document is dated March 31, 2022, and represents Change Order No. 1 to Task Assignment GC925-5. The contractor is Orange County, represented by David Jones, with Roger Ruiz serving as the DEP Contract Manager. All required signatures were executed via Adobe Signature between April 11 and April 12, 2022.
The change order increases funding for Variable Inspections by $20,000, resulting in a net increase to the total task amount from $766,850 to $786,850. The task completion date remains June 30, 2022, with no change to the project timeline. Funding is allocated under Org. Code 37450104000 with Object Code 132500, Budget Entity 37450300, and Special Category 100029, totaling $786,850.00. The change order was approved by Tameshia N. Reid (Budget Representative) and Teresa Booeshaghi (Contractual Authority), with copies 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:
GC925-5 03/31/2022 1
ORANGE COUNTY
David Jones
Roger Ruiz
Increase in funds for Variable Inspections for $20,000.
A net increase of $20,000.
766,850 766,850
766,850 766,850
+20,000 +20,000
786,850 786,850
06/30/22 06/30/22 +20,000 06/30/22
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 $ 786,850.00
David D. Jones Digitally signed by David D. Jones Date: 2022.04.11 17:40:56 -04'00' 04/11/2022 Roger Ruiz Digitally signed by Roger Ruiz
Date: 2022.04.12 08:33:55 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.04.12 10:44:51 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2022.04.12 10:50:42 -04'00'
File details come from the government source that posted it. Updated .