CN-370000-GC927-T5CO4.pdf
PDF 656 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) for DEP Contract GC927. The contractor is Lee County, represented by Lisa Kreiger, with Roger Ruiz serving as the FDEP Contract Manager. The change order was executed on April 20, 2022, and is identified as Change Order No. 4 to Task Assignment GC927-5.
The change order modifies the completion deadline for routine compliance inspections of storage tank systems at 425 facilities located within Lee, Charlotte, and DeSoto Counties, as identified in Exhibit #1. The original deadline of May 31, 2022, is extended to June 30, 2022. The task amount remains unchanged at $232,740.00, with funding allocated from Org. Code 37450104000 under E.O. JD, Object Code 132500, Budget Entity 37450300, and Special Category 100029. The change order was approved by Budget Representative Tameshia N. Reid and Contractual Authority Teresa Booeshaghi on April 20, 2022.
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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 04/20/2022 4
LEE COUNTY
Lisa Kreiger
Roger Ruiz
This change revises the sentence in Task Assignment #5 for DEP Contract GC927 reading:
"Conduct routine compliance inspections for storage tank systems at the 425 facilities within Lee, Charlotte and DeSoto Counties, identified in Exhibit #1, by May 31, 2022.", to read:
"Conduct routine compliance inspections for storage tank systems at the 425 facilities within Lee, Charlotte and DeSoto Counties, identified in Exhibit #1, by June 30, 2022."
222,740 222,740
232,740 232,740
232,740 232,740
06/30/22 06/30/22
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: 2022.04.20 09:05:58 -04'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2022.04.20 09:31:53 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2022.04.20 09:43:15 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2022.04.20 10:04:55 -04'00'
File details come from the government source that posted it. Updated .