Funding Information:

Org. Code E.O. Object Code Budget Entity Appropriation

Category Grant # Project # Year Amount

☐ Additional Funding Information attached on separate page.

Rev. 8/26/2020

STATE OF FLORIDA

DEPARTMENT OF ENVIRONMENTAL PROTECTION

Task Assignment This Task Assignment (TA) is entered into between the Parties named below, pursuant to Contract Number: .

1. TA Number: TA Completion Date:

TA Description:

2. Parties State of Florida Department of Environmental Protection

(Department)

Department Project Manager: Department Project Manager Phone:

Contractor Name: (Contractor ) ntractor’st ’s Project Manager: ontractor’s t’s Project Manager Phone:

3. Project Number:

(If different from TA Number)

Project Location(s):

Project Name:

4. As consideration for the services rendered by Contractor under the terms of this TA, the Department shall pay the Contractor on the following bases, up to the Total TA Value as indicated below:

☐ Fixed Price:

☐ Fixed Unit Rate: (Extended Price)

☐ Cost Reimbursement:

Total TA Value:

5. The Parties agree to comply with the terms and conditions of the underlying the Contract, and the following attachments which are hereby incorporated by reference:

Attachment 1:

☐ Additional Attachments (if necessary):

IN WITNESS WHEREOF, this TA shall be effective on the last date signed below.

State of Florida Department of Environmental Protection CONTRACTOR Department Name:

Title:

Secretary or Designee

(Authorized Signature) (Authorized Signature) Date:

☐ Additional signatures attached on separate page.

GW387

DWM-2 Expiration June 30, 2023

The Contractor will provide administrative staff and potable well identification and sampling services to the Department according to Contract GW387. Please see the attached pages for itemized Tasks.

Robert Perlowski 8502458917 Contractor Contractor

Contractor Contractor

Contractor Contractor

Contractor

Florida Department of Health

Florida Department of Health

Mike Berry 8509016486

Tallahassee Florida

Potable Well Survey and Sampling

✔ $ 465,765.00 ✔ $ 388,511.34

$ 854,276.34

Scope of Work

Michael Berry

OMC Manager

6/14/2022

Digitally signed by Michael Berry DN: C=US, OU=Bureau of Environmental Health, O=Florida Department of Heallth, CN=Michael Berry, E=michael.berry@flhealth.gov Reason: I am approving this document Location: your signing location here Date: 2022-06-14 11:43:44 Foxit PhantomPDF Version: 10.0.0

Michael Berry

JohnTruitt

John Truitt Digitally signed by John Truitt Date: 2022.06.20 10:37:19 -04'00'

6/20/2022

Funding Information

Petroleum Restoration Program (PRP) Funding Information

Org. Code EO Object Code

Budget Entity

Appropriation Category

Grant# Project# Year Amount

37450404555 JC 131545 37450300 104132 GW387 00 $502,553.26

Drycleaning Solvent Cleanup Program (DSCP) DSCP Funding Information

Budget Entity

Appropriation Category

37450202000 ZJ 131545 37450300 080524 GW387 22 $97,255.06

Office of District and Business Support (ODBS) Funding Information

Budget Entity

Appropriation Category

37450102000 ZB 131545 37450300 101492 GW387 00 $157,212.96

Drycleaning Solvent Cleanup Program (DSCP) and State PFAS Funding Information

Budget Entity

Appropriation Category

37450202000 ZJ 131545 37450300 080502 GW387 22 $97,255.06

ATTACHMENT A