CN-370000-GC927-T2CO1.pdf
PDF 1 MB Posted
- Contract number
- GC927
- Issued by
- Florida
About this file
Task Assignment Change Order Summary
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection (FDEP) dated July 25, 2018. The document modifies Task Assignment Number GC927-2 with Lee County, represented by Keith Kibbey, with FDEP Contract Manager Roger Ruiz overseeing the agreement. The change order was approved by FDEP personnel including Fletcher Herrald (Contract Manager), Jennifer Vickers (Budget Representative), and Tim J. Bahr (Contractual Authority).
The change order reflects an updated Attachment A – Scope of Work with an original task amount of $244,420.00. The task completion date remains June 30, 2019, with no net increase or decrease in the task period indicated. Funding is allocated through Organizational Code 37450104000, E.O. JD, Object Code 132500, Budget Entity 37450300, and Special Category 100029, with the full amount of $244,420.00 charged to Year 00. The document was executed with digital signatures on August 17, 2018, and copies were 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:
GC927-2 07/25/2018 1
LEE COUNTY
Keith Kibbey
Roger Ruiz
Updated Attachment A - Scope of Work
$244,420.00
06/30/19 06/30/19
06/30/19
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 $ 244,420.00
Keith Kibbey Digitally signed by Keith Kibbey DN: cn=Keith Kibbey, o=Lee County, ou=Natural Resources, email=kibbeyka@leegov.com, c=US Date: 2018.08.17 08:07:18 -04'00'
Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2018.08.17 09:22:58 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.08.17 09:39:59 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.08.17 09:46:39 -04'00'
File details come from the government source that posted it. Updated .