CN-370000-GC927-T1CO1.pdf
PDF 1 MB Posted
- Contract number
- GC927
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Form OOO-012) issued by the Florida Department of Environmental Protection for Task Assignment Number GC927-1 with Lee County. The change order was executed on August 2, 2017, and signed by Keith Kibbey (Contractor Representative for Lee County), Roger Ruiz (DEP Contract Manager), Jennifer Vickers (Budget Representative), and Tim J. Bahr (Contractual Authority) on August 9, 2017.
The change order modifies the pricing structure for routine inspection services. The unit cost per routine inspection increases from $510.40 to $515.50, representing a net increase of $5.10 per inspection. This price adjustment becomes effective September 1, 2017, with all inspections conducted through August 31, 2017, paid at the original rate of $510.40. The change order increases the total task amount by $2,779.50, bringing the task amount with all change orders to $280,947.50. The task completion date remains June 30, 2018. Funding is allocated from Org. Code 37450104000 under Object Code 132500 with Budget Entity 37450300, Special Category 100029, in the amount of $280,947.50.
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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:
GC927-1 08/02/2017 1
LEE COUNTY
Keith Kibbey
Roger Ruiz
Amount increase per Routine Inspection from $510.40 to $515.50.
A net increase of $5.10 per Routine Inspection.
The increase will become effective September 1, 2017. All inspections conducted through August 31, 2017, will be paid at the rate of $510.40.
278,168.00 278,168.00
278,168.00 278,168.00
2,779.50 2,779.50
280,947.50 280,947.50
06/30/18 06/30/18 2,779.50 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 00 $ 280,947.50
Keith Kibbey Digitally signed by Keith Kibbey DN: cn=Keith Kibbey, o=Lee County, ou=Natural Resources, email=kibbeyka@leegov.com, c=US Date: 2017.08.09 10:26:41 -04'00'
Roger Ruiz Digitally signed by Roger Ruiz Date: 2017.08.09 12:29:22 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2017.08.09 14:40:57 -04'00'
08/09/2017
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2017.08.09 17:23:18 -04'00'
File details come from the government source that posted it. Updated .