CN-370000-GW283-TOX13.pdf

Task Assignment Number: TOX13_

REVISED TASK ASSIGNMENT NOTIFICATION FORM

DEP CONTRACT NO. GW283

Date:_ 4/11/2018

Contractor: Florida Dei1artment of Health

Contractor Contract Coordinator. Michael Bern __ _

DEP Contract Manager: ;:::;C,..,ha°"rl""es"-Co=u"-"lta,,,,s,_ ____________ _ Phone Number:_245-8369 ______ _

Task D escription (Use additional sheets if necessary:J.!!_ac�ordance with DEP Contract GW283 and J\.Uachment C§.�ope ofServi�Jhe contractor will perfonn state-wi9e potable well surve�s and sampling on a fee schedule basis as outlined in Attachment D Fee Schedule for Well Surv.:\' & Sam,,Jim; Services sections I throu:,:h N for the Certification and Restoration Pro1nam. The Contractor agrees to ,rovide ini! to allow the Count, D<· ,artment of Health uni�1.1erfonn discretional water qualit \' sama,lini:. The contractor shall not

�ceed the limitsof)his Task Assfonment.

Deliverables: In accordance with the GW283 scope of services Attachments � H and I the well location information and analytical sampling results will be c;rovided electronically and suitable for use in GIS Access or Excel databases as appropriate.

Task Assignment Performance Period: Execution • _7'"""/""1/2=0'-'-1=-8 _-=6/=3=0/=20'""'1.,,_9 _______________ _

Task Assignment Type:

Fixed Price

Cost Reimbursement

Fee Schedule

Total Task Assignment Value

Funding Information:

Amount Not To Exceed:

$ 286 703.00

$_286,703.00 c:.O=r;;-'----'. Co=de:__ ___ L...;,Q_IFund ID !Obiect Code !Module IB.E. I Category I Grant# I Year l,�Am=o=u=nt ____ ____.

137 352040000 _ izg__lEDB � 8249 104134 _ 00 100 000.

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FLORIDA DEPARTMENT OF HEAL TH FLORIDA DEPARTMENT O EVIRONMENTAL PROT CTION

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Date C]:Z,� � (, �-

DEP Contract Manager

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DEP Contract Coordinator (Only for PRP) Date

Procurement Section Date

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ATTACHMENT D4

Revised Fee Schedule for Well Survey and Sampling Services

The Contractor shall be compensated In accordance with the following rates as evidenced by an executed Task Assignment Notification Form or Task Assignment Change Order Form.

ITEM .

FEE SCHEDULE

1. Drinking Water Well Surveyl Well Location

Well Survey Request( as outlined In Attachment C Scope of Services) 217.00/survey

GPS Well Location or Well Property Location( or if> 10 wells per request) 12.50/well

11. Drinking Water Sample Collection

Three or Less Water Samples from the same well 93.001well

More than three Water Samples from the same well 103.00twell

Ill. Out of County( additional fee for above services) 23.001surveyfiocaton/sample

IV. Miscellaneous Expenses

A. DEP User Licenses for DOH Lab Sample Manager information 6,684.00 system if requested by DEP( up to 4 at$ 1, 716 each)

B. Nitrate Field Screening Testing 5.001test

C. Request for CHD Assistance( no GPS location or well sampling 41. 00/ visit required)

D. Hands-on training session on water well surveying and sampling 700.001session conducted by CHD staff( one-day session for up to 6 staff)

V. Cost Reimbursement as Authorized by an Executed Task Assignment

A. Administrative Services

Administrative services costs shall be compensated on a cost reimbursement basis in the amount specified in each Task Assignment Notification Form and Change Order as outlined In paragraph S.A. of the Contract and Section VII of the Scope of Services. These costs shall be Invoiced on a quarterly basis.

B. Training and Travel

With the exception of training sessions conducted by CHD staff, the Contractor shall be reimbursed for the actual costs of training and travel up to the amount specified in each Task Assignment Notification Form and Change Order as outlined in Paragraph S.C. of the Contract and Section Vill of the Scope of Services. Ail associated travel expenses will be reimbursed In accordance with Section 112.061, F. S. These costs shall be invoiced on a quarterly basis.

DEP Contract No. GW283, Attachment D• 1, Page 1 of 2

C. Equipment Maintenance and Repair

The Contractor shall be reimbursed for the actual cost of maintenance and repairs of DEP and DOH owned GPS equipment as outlined in Paragraph S.C. of this Contract and Section Vill of the Scope of Services up to the amount specified In each Task Assignment Notification Form and Change Order. These costs shall be Invoiced on a quarterly basis.

D. Equipment Purchase/ Replacement

The Contractor shall be reimbursed for the actual cost of GPS equipment purchased as outlined in Paragraph S.C. of this Contract and Section Bill of the Scope of Services up to the amount specified in each Task Assignment Notification Form and Change Order. Any equipment purchased over$ 1, 000.00 will be the property of DEP and must be pre-authorized by DEP. Other equipment purchase requirements are specified in Paragraph 27, Section A through E of this contract Attachment F( Property Reporting Form) will be*used to list all equipment purchased under this contract

REMAINDER OF PAGE INTENTIONALLY LEFT BLANK

DEP Contract No. GW283, Attachment D- 1, Page 2 of 2

PROPOSED DOH COSTS PROPOSED DEP EXPENSES FIELD & LAB COSTS BREAKDOWN

BY PROGRAM

program office petroleum petroleum units $/unit petroleum 76.0% $467,978 surveys 3000 $217 $651,000 toxics 17.0% $104,679 $467,978 program office samples 6000 $93 $558,000 drycleaning 6.0% $36,946 $1,266,500 field costs lab 0 $0 $0 waste cleanup 1.0% $6,158 $1,734,478 total ooc 2500 $23 $57,500 total 100% $615,760 total $1,266,500 toxics TOX13 Breakdown toxics units $/unit field costs units $/unit $104,679 program office TOX12 surveys 25 $217 $5,425 surveys 3385 $217 $734,545 $286,703 field costs TOX13 samples 2745 $93 $255,285 samples 9168 $93 $852,624 $391,382 total Multiple Samples 48 $103 $4,944 Mult samples 48 $103 $4,944 ooc 602 $23 $13,846 out of county 3263 $23 $75,049 Field Assistance 8 $41 $328.00 GPS 550 $12.50 $6,875 drycleaning GPS Well Points 550 $12.50 $6,875.00 Assistance 8 $41 $328 total $286,703 total $1,674,365 $36,946 program office $99,983 field costs lab costs units $/unit $136,929 total drycleaning units $/unit VOC's 0 $0 $0 surveys 348 $217 $75,516 Toxics/WC 0 $0 $0 samples 248 $93 $23,064 total $0 waste cleanup lab 0 $0 $0 ooc 61 $23 $1,403

$6,158 program office total $99,983 $21,179 field costs $27,337 total waste cleanup units $/unit surveys 12 $217 $2,604 samples 175 $93 $16,275

FY 17/18 TOTAL $2,290,125 TOTAL $2,290,125 lab 0 $0 $0 ooc 100 $23 $2,300 total $21,179