CN-370000-GC927-T5CO2.pdf

PDF 655 KB Posted

Attached to
Master Agreement FL|GC927|adfed6b093109682e55afa87e225e538
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 January 13, 2022. The document modifies an existing task assignment (GC927-5) with Lee County. The contractor is represented by Lisa Kreiger, and the FDEP Contract Manager is Roger Ruiz. The change order has been approved by Tameshia N. Reid (Budget Representative) and Teresa Booeshaghi (Contractual Authority).

The change order increases funding for Variable Inspections by $10,000, resulting in a net increase to the task amount. The original task amount of $222,740 is increased to $232,740 with all change orders applied. The task completion date remains June 30, 2022, with no extension to the project timeline. Funding is allocated from Org. Code 37450104000 under Object Code 132500 (Budget Entity 37450300) with Special Category 100029, bringing the total contract value to $232,740.00.

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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:

GC927-5 01/13/2022 2

LEE COUNTY

Lisa Kreiger

Roger Ruiz

Increase in funds for Variable Inspections for $10,000.

A net increase of $10,000.

222,740 222,740

222,740 222,740

+10,000 +10,000

232,740 232,740

06/30/22 06/30/22 +10,000 06/30/22

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 $ 232,740.00

Lisa Kreiger Digitally signed by Lisa Kreiger Date: 2022.01.18 08:00:32 -05'00' Roger Ruiz Digitally signed by Roger Ruiz

Date: 2022.01.18 08:51:39 -05'00'

Tameshia N. Reid Digitally signed by Tameshia N.

Reid Date: 2022.01.24 08:09:22 -05'00'

Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2022.01.24 09:20:29 -05'00'

File details come from the government source that posted it. Updated .