CN-370000-GC927-T6CO2.pdf
PDF 655 KB Posted
- Contract number
- GC927
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 2) issued by the Florida Department of Environmental Protection (FDEP) dated June 8, 2023. The contractor is Lee County, represented by Rick Roudebush, with Roger Ruiz serving as the DEP Contract Manager. The change order pertains to Task Assignment Number GC927-6.
The change order increases the contract funding by $4,900 for Variable Inspections, raising the task amount from $249,925 to $254,825. The task completion date remains June 30, 2023, with no extension to the original timeline. The funding is allocated from organizational code 37450104000 using object code 132500 under budget entity 37450300, with special category code 100029. The change order has been approved by all required parties, including the Budget Representative (Tameshia N. Reid) and Contractual Authority (Teresa Booeshaghi), with signatures dated June 8-9, 2023. Copies are 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:
GC927-6 06/08/2023 2
LEE COUNTY
Rick Roudebush
Roger Ruiz
Increase in funds for Variable Inspections for $4,900.
A net increase of $4,900.
249,925 249,925
249,925 249,925
+4,900 +4,900
254,825 254,825
06/30/23 06/30/23 +4,900 06/30/23
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 $ 249,925.00
37450104000 JD 132500 37450300 100029 00 $ 4,900.00
Rick R.
Roudebush
Digitally signed by Rick R.
Roudebush Date: 2023.06.08 12:45:21 -04'00' Roger Ruiz Digitally signed by Roger Ruiz
Date: 2023.06.08 13:16:51 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2023.06.08 13:25:19 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2023.06.09 10:45:35 -04'00'
File details come from the government source that posted it. Updated .