CN-370000-GC928-T14CO3.pdf
PDF 338 KB Posted
- Contract number
- GC928
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form (Change Order No. 3) issued by the Florida Department of Environmental Protection (DEP) for DEP Contract GC928-14. The contractor is Citrus County, represented by Glenn W. Bryant, with Roger Ruiz serving as the DEP Contract Manager. The change order was executed on May 28, 2024, and has been approved by the Budget Representative (Tameshia N. Reid) and Contractual Authority (Teresa Booeshaghi).
The change order modifies Task Assignment #14 to extend the completion deadline for conducting routine compliance inspections of storage tank systems at 48 facilities within Sumter County from May 31, 2024, to June 30, 2024. The task amount remains unchanged at $50,720.66 total, consisting of the original task amount of $44,220.66, a prior change order increase of $4,300.00, and an additional increase of $2,200.00. Funding is allocated from Organization Code 37450104000 across three separate line items with Object Code 132500, Budget Entity 37450300, and Special Category 100029, all coded to Year 00. The change order extends the task completion date by one month while maintaining the established budget authority and funding sources.
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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 05/28/2024 3
CITRUS COUNTY
Glenn W. Bryant
Roger Ruiz
This change revises the sentence in Task Assignment #14 for DEP Contract GC928 reading:
"Conduct routine compliance inspections for storage tank systems at the 48 facilities within Sumter County, identified in Exhibit #1, by May 31, 2024.", to read:
"Conduct routine compliance inspections for storage tank systems at the 48 facilities within Sumter County, identified in Exhibit #1, by June 30, 2024."
44,220.66 44,220.66
48,520.66 48,520.66
50,720.66 50,720.66
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 $ 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: 2024.05.28 13:56:09 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.05.28 14:09:21 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.05.28 15:16:57 -04'00'
File details come from the government source that posted it. Updated .