CN-370000-GC927-T1CO2.pdf
PDF 654 KB Posted
- Contract number
- GC927
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 2) issued by the Florida Department of Environmental Protection (FDEP) on April 30, 2018, for a contract with Lee County. The form is executed by Keith Kibbey as the Contractor Representative from Lee County and Roger Ruiz as the DEP Contract Manager, with approval from Jennifer Vickers (Budget Representative) and Tim J. Bahr (Contractual Authority).
The change order reflects a reduction in funding for variable inspections, resulting in a net decrease of $27,000.00 to the task assignment GC927-1. The original task amount was $278,168.00, which had increased to $280,947.50 prior to this change order. Following this modification, the task amount with all change orders is $253,947.50. The task completion date remains unchanged at June 30, 2018. The funding is allocated from Organizational Code 37450104000 under Object Code 132500 (Budget Entity 37450300, Special Category 100029) with a total 2018 budget amount of $253,947.50. Copies of the change order are to be distributed to the Procurement Section (MS93) and 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:
GC927-1 04/30/2018 2
LEE COUNTY
Keith Kibbey
Roger Ruiz
Reduction on funding for Variable Inspections.
A net decrease of $27,000.00.
278,168.00 278,168.00
280,947.50 280,947.50
(27,000.00) (27,000.00)
253,947.50 253,947.50
06/30/18 06/30/18 (27,000.00) 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 2018 $ 253,947.50
Keith Kibbey Digitally signed by Keith Kibbey DN: cn=Keith Kibbey, o=Lee County, ou=Natural Resources, email=kibbeyka@leegov.com, c=US Date: 2018.05.09 13:16:56 -04'00'
Roger Ruiz Digitally signed by Roger Ruiz Date: 2018.05.09 13:22:50 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.05.09 13:41:45 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.05.09 14:53:31 -04'00'
File details come from the government source that posted it. Updated .