CN-370000-GC928-T14CO2.pdf
PDF 334 KB Posted
- Contract number
- GC928
- 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 April 22, 2024. The document modifies an existing task assignment (GC928-14) with Citrus County. Glenn W. Bryant represents the contractor, and Roger Ruiz serves as the DEP Contract Manager. 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 $2,200. The original task amount was $44,220.66, which had been increased to $48,520.66 prior to this change order. With the additional $2,200 increase, the total task amount with all change orders is now $50,720.66. The task completion date remains June 30, 2024. Funding is allocated from Org. Code 37450104000 under Object Code 132500, Budget Entity 37450300, Special Category 100029, with three separate line items totaling $44,220.66, $4,300.00, and $2,200.00 respectively.
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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:
GC928-14 04/22/2024 2
CITRUS COUNTY
Glenn W. Bryant
Roger Ruiz
Increase in funds for Variable Inspections for $2,200.
A net increase of $2,200.
44,220.66 44,220.66
48,520.66 48,520.66
+2,200 +2,200
50,720.66 50,720.66
06/30/24 06/30/24 +2,200 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 $ 44,220.66
37450104000 JD 132500 37450300 100029 00 $ 4,300.00
37450104000 JD 132500 37450300 100029 00 $ 2,200.00
Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.04.22 12:42:00 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.04.29 08:51:08 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.04.29 10:05:07 -04'00'
File details come from the government source that posted it. Updated .