CN-370000-GC928-T3CO3.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. 3) issued by the Florida Department of Environmental Protection (DEP) dated April 10, 2019. The document involves Citrus County as the contractor, with Glenn W. Bryant serving as the Contractor Representative and Roger Ruiz as the DEP Contract Manager. The change order is associated with Task Assignment Number GC928-3 and requires Adobe Signature authentication.
The change order modifies language in the existing task assignment regarding inspection staff attendance at an annual meeting scheduled for Spring 2019. Specifically, the change removes a fixed rate of $400 per staff member from the original task description, revising it to simply state "Inspection staff to attend annual meeting Spring 2019." This modification was made to ensure that reimbursement for travel costs complies with Chapter 112, Florida Statutes. The change order explicitly confirms that no changes to funding amounts or other contract information were affected by this modification. The task completion date remains June 30, 2019, with no adjustments to the task period or timeline. All required signatures from the contractor, DEP Contract Manager, Budget Representative, and Contractual Authority have been obtained.
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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:
GC928-3 04/10/2019 3
CITRUS COUNTY
Glenn W. Bryant
Roger Ruiz
“Revising sentence in current task assignment from reading :
‘Inspection staff to attend annual meeting Spring 2019 at a rate of $400 per staff member.’
To read:
Inspection staff to attend annual meeting Spring 2019.”
This is necessary to ensure reimbursement for travel costs shall be in compliance with Chapter 112, FS.
No changes in funding amount or information effected by this Task Assignment Change Order (TACO).
06/30/19 06/30/19
06/30/19
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
Digitally signed by Glenn W_ Bryant DN: C=US, OU=EPH, O=FL DOH Citrus, CN=Glenn W_ Bryant, E=glenn.bryant@flhealth.gov Reason: I am the author of this document Location:
Date: 2019-04-10 16:41:50 Foxit Reader Version: 9.3.0
Glenn W_ Bryant
04/10/2019 Roger Ruiz Digitally signed by Roger Ruiz Date: 2019.04.11 09:06:30 -04'00'
Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2019.04.11 09:17:58 -04'00'
Fletcher Herrald Digitally signed by Fletcher Herrald Date: 2019.04.11 09:18:14 -04'00'
File details come from the government source that posted it. Updated .