CN-370000-GC928-T16CO1.pdf
PDF 326 KB Posted
- Contract number
- GC928
- Issued by
- Florida
About this file
This is a Task Assignment Change Order Form issued by the Florida Department of Environmental Protection (FDEP) on October 22, 2024. The document pertains to Task Assignment Number GC928-16 involving Citrus County and is designated as Change Order No. 1. The contractor is represented by Glenn W. Bryant, while Roger Ruiz serves as the FDEP Contract Manager. The form has been approved by Tameshia N. Reid (Budget Representative) and Teresa Booeshaghi (Contractual Authority).
The change order addresses performance measure adjustments due to impacts from Hurricane Milton. For invoice 4 of the GC928-16 Citrus (Sumter) County contract, the contractor shall complete 26 percent, or 13 Routine Compliance Inspections. The original task amount of $51,640.66 remains unchanged, with no net increase or decrease in the task amount. The task completion date remains June 30, 2025, with no change to the task timeline. Funding for this change order is sourced from Organizational Code 37450100000 under E.O. JD, Object Code 132500, Budget Entity 37450300, Special Category 100029, and Year 00, with an amount of $51,640.66.
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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:
GC928-16 10/22/2024 1
CITRUS COUNTY
Glenn W. Bryant
Roger Ruiz
Performance Measures:
Due to storm impacts (Milton), for invoice 4, GC928-16 Citrus (Sumter) County, shall complete (26%) or 13 Routine Compliance Inspections.
51,640.66 51,640.66
06/30/25 06/30/25
06/30/25
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
37450100000 JD 132500 37450300 100029 00 $ 51,640.66
10/23/2024 Roger Ruiz Digitally signed by Roger Ruiz Date: 2024.10.23 15:26:52 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2024.10.23 16:10:00 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.10.23 16:43:26 -04'00'
File details come from the government source that posted it. Updated .