CN-370000-GC927-T2CO2.pdf
PDF 710 KB Posted
- Contract number
- GC927
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) dated February 12, 2019. The document modifies an existing task assignment contract between the FDEP and Lee County, with Keith Kibbey serving as the contractor representative and Roger Ruiz as the DEP Contract Manager.
The change order increases funding for variable inspections by $5,000.00, bringing the total task amount from $244,420.00 to $249,420.00. The task completion date remains unchanged at June 30, 2019. Funding sources include two budget lines: $244,420.00 allocated to special category 100029 and $5,000.00 allocated to special category 104138, both under organization code 37450104000, E.O. codes JD and JN respectively, object code 132500, and budget entity 37450300. The change order received approval from the Florida Department of Environmental Protection's Contract Manager, Budget Representative Jennifer Vickers, and Contractual Authority Fletcher Herrald on February 13, 2019.
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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 02/12/2019 2
LEE COUNTY
Keith Kibbey
Roger Ruiz
Increase of Funds for Variable Inspections in the amount of $5,000.00
$244,420.00 $244,420.00
$244,420.00 $244,420.00
+$5,000.00 +$5,000.00
$249,420.00 $249,420.00
06/30/19 06/30/19 +$5,000.00 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
37450104000 JN 132500 37450300 104138 00 $ 5,000.00
$ 249,420.00
Roger Ruiz Digitally signed by Roger Ruiz Date: 2019.02.13 09:51:01 -05'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2019.02.13 16:01:57 -05'00'
Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2019.02.13 16:58:50 -05'00'
Keith Kibb ey
Digitally signed by Keith Kibbey DN: cn=Keith Kibbey, o=Lee County, ou=Natural Resources, email=kibbeyka@le egov.com, c=US Date: 2019.02.13 09:36:26 -05'00'
File details come from the government source that posted it. Updated .