CN-370000-GC928-T1CO2.pdf
PDF 534 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 19, 2018. The document pertains to a task assignment with Citrus County, represented by Glenn W. Bryant, with FDEP Contract Manager Roger Ruiz overseeing the contract under Task Assignment Number GC928-1.
The change order reflects a reduction in funding for Variable Inspections in the amount of $10,000.00. The original task amount was $95,286.58, which had been increased to $96,238.70 prior to this change order. With the net decrease of $10,000.00, the final task amount following all change orders is $86,238.70. The task completion date remains unchanged at June 30, 2018. The funding is allocated from Organizational Code 37450104000 under E.O. JD with Object Code 132500, Budget Entity 37450300, Special Category 100029, for fiscal year 2018. The change order was approved by Budget Representative Jennifer Vickers and Contractual Authority Tim J. Bahr on May 1 and May 9, 2018, 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:
GC928-1 04/19/2018 2
CITRUS COUNTY
Glenn W. Bryant
Roger Ruiz
Reduction on funding for Variable Inspections.
A net decrease of $10,000.00.
95,286.58 95,286.58
96,238.70 96,238.70
(10,000.00) (10,000.00)
86,238.70 86,238.70
06/30/18 06/30/18 (10,000.00) 06/30/18
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 2018 $ 86,238.70
Digitally signed by Glenn W_ Bryant DN: C=US, OU=FL DOH Citrus, CN=Glenn W_ Bryant, E=glenn_bryant@flhealth.gov Reason: I am approving this document Location:
Date: 2018-04-30 10:35:43
Glenn W_ Bryant
Roger Ruiz Digitally signed by Roger Ruiz Date: 2018.04.30 10:51:18 -04'00'
Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2018.05.01 10:40:15 -04'00'
Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2018.05.09 15:27:08 -04'00'
File details come from the government source that posted it. Updated .