CN-370000-GC928-T13CO3.pdf
PDF 340 KB Posted
- Contract number
- GC145
- Issued by
- Florida
About this file
This document is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (DEP), involving Citrus County as the contractor. The change order is for DEP Contract GC928, Task Assignment #13, with the contract manager Roger Ruiz and contractor representative Glenn W. Bryant.
The change order extends the completion date for routine compliance inspections of storage tank systems from May 31, 2024, to June 30, 2024, covering 119 facilities within Citrus and Hernando Counties. The original task amount was $104,356.41, which was slightly adjusted to $102,056.41 prior to this change order, and the final task amount with all change orders is $109,056.41. The funding information shows the changes are being made under Org. Code 37450104000, with a budget entity of 37450300 and special category 100029.
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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:
GC928-13 05/28/2024 3
CITRUS COUNTY
Glenn W. Bryant
Roger Ruiz
This change revises the sentence in Task Assignment #13 for DEP Contract GC928 reading:
"Conduct routine compliance inspections for storage tank systems at the 119 facilities within Citrus and Hernando Counties, identified in Exhibit #1, by May 31, 2024.", to read:
"Conduct routine compliance inspections for storage tank systems at the 119 facilities within Citrus and Hernando Counties, identified in Exhibit #1, by June 30, 2024."
104,356.41 104,356.41
102,056.41 102,056.41
109,056.41 109,056.41
06/30/24 06/30/24
06/30/24
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 $ 104,356.41
37450104000 JD 132500 37450300 100029 00 -$ 2,300.00
37450104000 JD 132500 37450300 100029 00 $ 7,000.00
Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.05.28 13:58:03 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.05.28 14:08:07 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.05.28 14:54:04 -04'00'
File details come from the government source that posted it. Updated .