Task Assignment Change Order Form Summary

This is a Task Assignment Change Order Form (Change Order Number 1) for Contract No. GW283 between the Florida Department of Health (contractor) and the Florida Department of Environmental Protection (contracting agency). The contract coordinator is Michael Berry, and the DEP Contract Manager is Charles Coultas. Task Assignment TOX7 is the subject of this modification.

The change order authorizes an extension of two additional months for Potable Well Surveys and Sampling services, extending the service period to September 30, 2015, with a corresponding funding increase of $47,784.00. The deliverables schedule is modified from quarterly to monthly reporting. The original task amount was $23,892.00, with the change order adding $47,784.00 for a cumulative task amount of $71,676.00. The original completion date was July 31, 2015; the modification extends the completion date by two months to September 30, 2015. Funding is allocated across three organizational codes with total amounts of $14,335.20, $28,670.40, and $4,778.40. The change order was approved and signed by representatives from both agencies on July 31, 2015 and July 29, 2015, respectively.