CN-370000-GC928-T16CO2.pdf
PDF 336 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 (DEP) for Task Assignment GC928-16 with the contractor Citrus County. The change order was executed on May 20, 2025, with Glenn W. Bryant serving as the Contractor Representative and Roger Ruiz as the DEP Contract Manager. The document was approved by Tameshia N. Reid (Budget Representative) and Natasha Lampkin (Contractual Authority).
The change order modifies the completion deadline for routine compliance inspections of storage tank systems at 51 facilities within Sumter County, as identified in Exhibit #1. The original completion date of May 31, 2025, has been extended to June 30, 2025. The task amount remains unchanged at $51,640.66, funded through organizational code 37450100000 with object code 132500 under budget entity 37450300 and special category 100029. No adjustments were made to the contract pricing, and the funding source and amount remain constant throughout the change order.
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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 05/20/2025 2
CITRUS COUNTY
Glenn W. Bryant
Roger Ruiz
This change revises the sentence in Task Assignment #16 for DEP Contract GC928 reading:
"Conduct routine compliance inspections for storage tank systems at the 51 facilities within Sumter County, identified in Exhibit #1, by May 31, 2025.", to read:
"Conduct routine compliance inspections for storage tank systems at the 51 facilities within Sumter County, identified in Exhibit #1, by June 30, 2025."
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
05/20/2025 Roger Ruiz Digitally signed by Roger Ruiz Date: 2025.05.20 15:47:11 -04'00'
Tameshia N. Reid Digitally signed by Tameshia N.
Reid Date: 2025.05.21 08:39:16 -04'00'
Natasha Lampkin Digitally signed by Natasha Lampkin Date: 2025.05.21 08:59:29 -04'00'
File details come from the government source that posted it. Updated .