CN-370000-GW387-TOX17.pdf

REVISED TASK ASSIGNMENT CHANGE ORDER FORM

DEP CONTRACT NO. GW387 CHANGE ORDER 1

Task Assignment Number: TOX16 Date: __7/1/20_____________________________

Contractor: Florida Department of Health

Contractor Representative: Michael Berry, OMC Manager, Florida Department of Health

DEP Contract Manager: Robert Perlowski, Florida Department of Environmental Protection

DEP Manager: Lauren Coleman, P.E. Florida Department of Environmental Protection

Task Description: In accordance with DEP Contract GW387 the contractor shall provide Administrative Services not exceeding $72,985.00 and perform state-wide Potable Well Surveys and Sampling not exceeding $224,605.00 as specified in Attachment B (Rate Schedule) for one year at a cost reimbursement fee schedule. The contractor is not authorized to perform any services that exceed this funding amount for FY20/21. The contractor will perform 25 potable well surveys at $225.00 each for a total of $5,625.00, 2000 sampling events at $95.00 each for a total of $190,000.00, 48 Multiple Samples at 110.00 each for a total of $5,280.00, 602 Out of County events at 25.00 each for a total of $15,050.00, 8 Field Assistance (units) at $50.00 each for a total of $400.00, 550 GPS Well Points at $15.00 each for a total of $8,250.00 for the Water Supply Restoration Funding Program

Deliverables: When work Is performed, Deliverables are due as described In Tasks 1-10 of Contract GW387.

Performance Measures: All work must be in accordance with the Standard Operating Procedures, terms, and conditions of Contract GW387. The Contractor represents that Its services shall be performed in a manner consistent with the level of care and skill ordinarily exercised by other professional consultants under similar circumstances at the time the services are performed.

Financial Consequences: Failure to implement any of the terms and conditions of this Task Assignment shall be considered a breach of contract and shall subject the Contractor to cancellation of this Task Assignment, loss of payment, or termination of the Contract.

Period of Performance: Execution of Task Assignment through June 30, 2021.

TASK ASSIGNMENT TYPE AND NOT TO EXCEED AMOUNTS:

TOTAL TASK ASSIGNMENT VALUE $297,590.00

Funding Information:

Org Code EO Fund ID Object Code

Module BE Category Grant# Year Amount

37352040000 ZE 780001 139900 8249 104134 NA 00 $104,496.00

37352040000 ZB 780001 139900 8249 101492 NA 00 $122,594.00

37352040000 JC 212001 139900 NA 104132 NA 00 $70,500.00

FLORIDA DEPARTMENT OF HEALTH FLORIDA DEPARTMENT OF

EVIRONMENTAL PROTECTION

DOH Contract Manager Date DEP Contract Manager Date

APPROVED:

Budget Authority Date

Contractual Authority Date

FEE SCHEDULE COST REIMBURSEMENT

Cost Reimbursement $297,590.00

H Contract Manager r

06/30/2020

37220100

37220100

37220100

Lauren Coleman Digitally signed by Lauren Coleman Date: 2020.06.30 12:16:37 -04'00'

Jennifer Vickers Digitally signed by Jennifer Vickers Date: 2020.06.30 13:02:22 -04'00'

Trina Vielhauer Digitally signed by Trina Vielhauer Date: 2020.06.30 13:39:39 -04'00'

Priest_T Typewritten Text

XXXX

Priest_T Typewritten Text

TOX 17

Priest_T Typewritten Text tp

P

R O

PO

SE

D D

O H

C O

ST

S

P

R O

PO

SE

D D

EP

E

XP

EN

SE

S

FI

EL

D

L

AB

C O

ST

S

B R

EA

K

D O

W N

B

Y

PR

O G

R

AM

pr og ra m o ffi ce pe tro le um pe tro le um un its un it pe tro le um

.0

$4

,9 su rv ey s

$2

$6

,0 to xi cs

.0

$7

2, $4

,9 p ro gr am o ffi ce sa m pl es

$9

$5

,0 dr yc le an in g 6.

0% $3

6, $1

,3

,5 fie ld c os ts oo c

$2

$6 2, wa st e cl ea nu p

.0

$6 0, $1 ,7

,4 to ta l l $1

,3 l

0%

$6

,2 to xi cs un its un it to xi cs su rv ey s

$2

$5 ,6 sa m pl es

$9

$1

,0 f ie ld c os ts un its un it

$7 2, gr am o ffi ce

M ul tip le

S am pl es

$1

$5

,2 su rv ey s

$2

$7

,1

$2

,6 c os ts oo c

$2

$1 5, su rv ey s

(1 /2

-1 m ile

$4

$6

,3

$2 l

Fi el d As si st an ce

$5

$4

.0 su rv ey s (1

-2 m ile

$6

$6

,3

G

PS

W el l P oi nt s

$1 5.

$8

,2

.0 su rv ey s m ile

$1 ,1

$5

,6 l

$2

,6 sa m pl es

$9

$9

,0 dr yc le an in g

M ul t s am pl es

$1

$5

,2 dr yc le an in g un its un it ou t o f c ou nt y

$2

$8

6, $3

6, gr am o ffi ce su rv ey s

$2

$7

8, G

PS

$1

5.

$8 ,2

$1

,3 c os ts sa m pl es

$9

$2

3, As si st an ce

$5

$4

$1

,8 l oo c

$2

$1 l $1

,8

,9 l

$1

,3 wa st e cl ea nu p wa st e cl ea nu p un its un it su rv ey s

$2

$2 ,2

$6

0, gr am o ffi ce su rv ey s (1

/2 -1 m ile

$4

$6 ,3

$1

,4 c os ts su rv ey s (1

-2 m ile

$6

$6

,3

$2

,2 l su rv ey s m ile

$1 ,1

$5

,6 sa m pl es

$9

$1

,5 oo c

$2

$7 l $1

,4

FY

9/

TO

TA

L

$2 ,4

,1

TO

TA

L

$2 ,4

,1