CN-370000-GC927-T3CO3.pdf
PDF 655 KB Posted
- Contract number
- GC927
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection (FDEP) on June 11, 2020. The change order modifies Task Assignment #3 under DEP Contract GC927 with Lee County, represented by contractor representative Lisa Kreiger. The FDEP Contract Manager is Roger Ruiz. The change order was approved by Monica J. Brady (Budget Representative) and Teresa Booeshaghi (Contractual Authority).
The change order extends the completion deadline for routine compliance inspections of storage tank systems at 424 facilities across Lee, Charlotte, and DeSoto Counties from May 31, 2020 to June 30, 2020. The task amount remains unchanged at $235,522, with no net increase or decrease in the contract value. Funding is allocated through Org. Code 37450104000 under Object Code 132500, Budget Entity 37450300, Special Category 100029, in the amount of $235,522.00 for fiscal year 2020.
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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:
GC927-3 06/11/2020 3
LEE COUNTY
Lisa Kreiger
Roger Ruiz
This change revises the sentence in Task Assignment #3 for DEP Contract GC927 reading:
"Conduct routine compliance inspections for storage tank systems at the 424 facilities within Lee, Charlotte, and DeSoto Counties, identified in Exhibit #1, by May 31, 2020.", to read:
"Conduct routine compliance inspections for storage tank systems at the 424 facilities within Lee, Charlotte, and DeSoto Counties, identified in Exhibit #1, by June 30, 2020."
241,358 241,358
235,522 235,522
235,522 235,522
06/30/20 06/30/20
06/30/20
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 $ 235,522.00
Lisa Kreiger Digitally signed by Lisa Kreiger Date: 2020.06.12 13:50:51 -04'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2020.06.15 10:23:22 -04'00'
Monica J. Brady Digitally signed by Monica J.
Brady Date: 2020.06.15 10:30:05 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2020.06.15 10:55:33 -04'00'
File details come from the government source that posted it. Updated .