CN-370000-HW550-SA138.pdf

DEP CONTRACT NO.

Task Assignment #: Module #: Grant #:

Contractor Name:

Contractor Representative:

DEP Contract Manager: Phone #:

DEP Site #:

Site Name:

Address(Street, City, County):

Phase:

Task Description [use additional pages if necessary]:

The Deliverable and Invoice Schedule is attached.

Final Deliverables:

Final Deliverable Due Date:

TASK ASSIGNMENT TYPE AND NOT TO EXCEED AMOUNTS:

FIXED FEE

RETAINAGE:

TOTAL TASK ASSIGNMENT VALUE: $0.00

DEP Task Manager:

DEP Contract Manager:

Contractual Authority:

Contractor Representative:

CC: Procurement Section (MS 93) Section Representative ________

TASK ASSIGNMENT NOTIFICATION FORM

COST PLUS FIXED FEE

COST REIMBURSEMENT

FIXED PRICE FEE SCHEDULE

Period of Performance:

Execution of Task Assignment through:

DEP will review the deliverables to verify that they meet the specifications of this contract and task description. DEP’s Contract Manager shall notify the Contractor of any deficiencies in the deliverable(s) and shall give the Contractor reasonable opportunity to correct noted deficiencies and provide a revised deliverable(s).

WCP TAFORM 01_18

HW550

N/A N/ASOL-0A138

Geosyntec

Todd Kafka

850-245-8970Brandie Stringer

ERIC_6136

Northeast Florida State Hospital

7487 S State Rd 121, Macclenny, Baker Co

Closure

In preparation for site closure, Geosyntec will develop a Site Rehabilitation Completion Report for the Northeast Florida State Hospital site, as detailed in the attached August 4, 2021 Geosyntec proposal.

Site Rehabilitation Completion Report

09/30/2021

11/30/2021

$ 3,370.44 $ 0.00 $ 0.00 $ 0.00

$ 0.00

Brandie Stringer Digitally signed by Brandie Stringer Date: 2021.08.12 13:11:26 -04'00'

Brandie Stringer Digitally signed by Brandie Stringer Date: 2021.08.12 13:11:52 -04'00'

David Phillips Digitally signed by David Phillips Date: 2021.08.12 13:48:55 -04'00'

Todd K. Kafka, PG Digitally signed by Todd K. Kafka, PG Date: 2021.08.12 14:29:29 -04'00'

$ 3,370.44

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

WCP TAFORM 04-2017

Contract Number:

Task Assignment #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

Site Rehabilitation Completion Report 09/30/2021

FDEP approval of Site Rehabilitation Completion Report - Subtasks 1-3 $ 3,370.44

$ 3,370.44

HW550

SOL-0A138

FLORIDA DEPARTMENT OF

Environmental Protection

Bob Martinez Center

2600 Blair Stone Road Tallahassee, FL 32399-2400

Ron DeSantis Governor

Jeanette Nuñez

Lt. Governor

Shawn Hamilton Interim Secretary

Memorandum

TO: Site # ERIC_6136

Northeast Florida State Hospital File

FROM: Brandie Stringer, Contract Manager

SUBJECT: Negotiation Summary

HW550 SOL-0A138

Site Rehabilitation Closure Report

DATE: August 12, 2021

In preparation for site closure, Geosyntec will develop a Site Rehabilitation Completion Report for the Northeast Florida State Hospital site, as detailed in the attached August 4, 2021 Geosyntec proposal.

Total task amount is $3,370.44. Negotiations resulted in saving the Department $1,351.59. Geosyntec’s time, labor, and subcontractor costs for these activities have been reviewed and are appropriate. The level-of-effort and cost estimate are reasonable for the scope of services. Final deliverable is due September 30, 2021.

Task completion date is November 30, 2021.

FDEP COST ESTIMATEContractor: Geosyntec Consultants

Date: 8/4/2021

Task #: HW550 SOL-0A138 SubTask 1 Project Management SubTask 6

Site: NEFSH AOC 4 SubTask 2 Work Plan and LOE SubTask 7

Activity/Phase: SRCR SubTask 3 SRCR Development and Submittal SubTask 8

Project Manager: Teresa Fischer SubTask 4 SubTask 9

SubTask 5 SubTask 10

Totals 1 2 3 4 5 6 7 8 9 10 Labor Rate Category

Geosyntec Consultants $57.69 Project Manager (TF) 2 2.1

$1.00 Sr. Principal 0 0 0 0 0 0 0 0 0 0 $1.00 Principal 0 0 0 0 0 0 0 0 0 0

$57.69 Principal (TF) 6 2 4 0 0 0 0 0 0 0 $1.00 Senior Professional 0 0 0 0 0 0 0 0 0 0 $1.00 Senior Professional 0 0 0 0 0 0 0 0 0 0 $1.00 Senior Professional 0 0 0 0 0 0 0 0 0 0

$40.38 Project Professional (BD) 12 0 12 0 0 0 0 0 0 0 $1.00 Professional 0 0 0 0 0 0 0 0 0 0

$40.38 Project Professional (MH) 3 0 3 0 0 0 0 0 0 0 $1.00 Project Professional 0 0 0 0 0 0 0 0 0 0

$28.85 Staff Professional (SH) 0 0 0 0 0 0 0 0 0 0 $1.00 Senior Staff Professional 0 0 0 0 0 0 0 0 0 0 $1.00 Senior Staff Professional 0 0 0 0 0 0 0 0 0 0 $1.00 Senior Staff Professional 0 0 0 0 0 0 0 0 0 0 $1.00 Staff Professional 0 0 0 0 0 0 0 0 0 0 $1.00 Staff Professional 0 0 0 0 0 0 0 0 0 0 $1.00 Staff Professional 0 0 0 0 0 0 0 0 0 0 $1.00 Staff Professional 0 0 0 0 0 0 0 0 0 0 $1.00 Clerical 0 0 0 0 0 0 0 0 0 0 $1.00 Clerical 0 0 0 0 0 0 0 0 0 0

$30.53 Admin Asst (PG) 1 0 1 0 0 0 0 0 0 0 $1.00 SR Drafter/SR CADD 0 0 0 0 0 0 0 0 0 0 $1.00 Project Professional 0 0 0 0 0 0 0 0 0 0 $1.00 Designer 0 0 0 0 0 0 0 0 0 0 $0.00 Site Manager 0 0 0 0 0 0 0 0 0 0 $1.00 Site Manager 0 0 0 0 0 0 0 0 0 0 $1.00 Senior Engineering Technician 0 0 0 0 0 0 0 0 0 0 $1.00 Engineering Technician 0 0 0 0 0 0 0 0 0 0

Total Hours 24 2 2 20 0 0 0 0 0 0 0

Direct Labor $1,105.17 $122.80 $115.38 $866.99 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Overhead 172.70% $1,908.63 $212.08 $199.26 $1,497.29 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Labor $3,013.80 $334.88 $314.64 $2,364.28 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Other Direct Costs $55.26 $6.14 $5.77 $43.35 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

REV: 02/03 CEF_GEO.XLS Page 1

FDEP COST ESTIMATEContractor: Geosyntec Consultants

Date: 8/4/2021

Task #: HW550 SOL-0A138 SubTask 1 Project Management SubTask 6

Site: NEFSH AOC 4 SubTask 2 Work Plan and LOE SubTask 7

Activity/Phase: SRCR SubTask 3 SRCR Development and Submittal SubTask 8

Project Manager: Teresa Fischer SubTask 4 SubTask 9

SubTask 5 SubTask 10

Totals 1 2 3 4 5 6 7 8 9 10 Travel

Vehicle Rental $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Mileage Costs $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Air Fare $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Per diem + Hotel $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Travel $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor (Equipment Procurement) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Procurement Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor (Services Procurement) Drilling (Conventional) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Drilling (Non-conventional) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Mobile Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Surveying $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

IDW $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Utilities $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Handling Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Laboratory Analytical Costs $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fast Turnaround Charges $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Sample Shipping $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Field Expenses Personal Protection $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Expendables $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Drilling related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Analytical related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (IDW related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Other) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Field Expenses $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subtotal $3,069.06 $341.02 $320.41 $2,407.63 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Completion Fee $301.38 $33.49 $31.46 $236.43 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Total Estimated Cost $3,370.44 $374.51 $351.87 $2,644.06 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

REV: 02/03 CEF_GEO.XLS Page 2

LEVEL OF EFFORT/EXPENSE WORKSHEET (Haz. Waste Dept.)

SITE : NEFSH AOC 4

SUBTASK: Work Plan and LOE

DATE: 8/4/21

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Sr. Principal

Principal

Principal (T. Fischer) 2

Professional

Site Manager

Geologist

GIS

Admin

TOTAL LABOR 2

TRAVEL

TYPE RATE UNIT USAGE TOTALS

Vehicle Rental Truck $410.00 week 0 $0.00 Truck $97.00 day 0 $0.00 Car $68.00 day 0 $0.00 subtotal $0.00

Mileage Costs 0.585 mile 0 $0.00 subtotal $0.00

Air Fare $1.00 Round Trip 0 $0.00 subtotal $0.00

Per diem ($35/75)

$35.00 days 0 $0.00

$75.00 days 0 $0.00 subtotal $0.00

TOTAL TRAVEL $0.00

SUBCONTRACTOR (EQUIPMENT PROCUREMENT)

NAME PURPOSE RATE UNIT USAGE TOTALS

None $0.00 Lump sum 0 $0.00 None $0.00 Lump sum 0 $0.00 None $0.00 Lump sum 0 $0.00

None $0.00 Lump sum 0 $0.00

TOTAL SUBCONTRACTOR (EQUIPMENT) $0.00

SUBCONTRACTOR (SERVICES PROCUREMENT)

NAME PURPOSE RATE UNIT USAGE TOTALS

Drilling (Conventional)

$0.00 Lump Sum 0 $0.00 $0.00 Lump Sum 0 $0.00 subtotal $0.00 Drilling (Non-Conventional)

$0.00 Lump Sum 0 $0.00 $0.00 Lump Sum 0 $0.00 subtotal $0.00 Mobile Laboratory

$0.00 Lump Sum 0 $0.00 subtotal $0.00

Surveying $0.00 Lump Sum 0 $0.00 subtotal $0.00

IDW

$0.00 Lump Sum 0 $0.00 $0.00 Lump Sum 0 $0.00 subtotal $0.00

Utilities $0.00 Month 0 $0.00 $0.00 Month 0 $0.00 subtotal $0.00

Other None $0.00 Month 0 $0.00 None $0.00 Month 0 $0.00 None $0.00 Month 0 $0.00 None $0.00 Month 0 $0.00 subtotal $0.00

TOTAL SUBCONTRACTOR (SERVICES) $0.00

Development of Work Plan and LOE

SL-0A13X_CEF_rev 8/12/2021 Page 1 of 2 Subtask 2

LEVEL OF EFFORT/EXPENSE WORKSHEET (Haz. Waste Dept.)

SITE : NEFSH AOC 4

SUBTASK: SRCR Development and Submitta

DATE: 8/4/21

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Sr. Principal

Principal

Principal (T. Fischer) 4

Project Professional (B. Dawson) 12

Staff Professional

Staff Professional

Project Professional (M. Hensley) 3

Admin (P. Gallager) 1

TOTAL LABOR 20

TRAVEL

TYPE RATE UNIT USAGE TOTALS

Vehicle Rental Truck $410.00 week 0 $0.00 Truck $97.00 day 0 $0.00 Car $68.00 day 0 $0.00 subtotal $0.00

Mileage Costs 0.585 mile 0 $0.00 subtotal $0.00

Air Fare $1.00 Round Trip 0 $0.00 subtotal $0.00

Per diem ($35/75)

$36.00 days 0 $0.00

$125.00 days 0 $0.00 subtotal $0.00

TOTAL TRAVEL $0.00

SUBCONTRACTOR (EQUIPMENT PROCUREMENT)

NAME PURPOSE RATE UNIT USAGE TOTALS

None $0.00 Lump sum 0 $0.00 None $0.00 Lump sum 0 $0.00 None $0.00 Lump sum 0 $0.00

None $0.00 Lump sum 0 $0.00

TOTAL SUBCONTRACTOR (EQUIPMENT) $0.00

SUBCONTRACTOR (SERVICES PROCUREMENT)

NAME PURPOSE RATE UNIT USAGE TOTALS

Drilling (Conventional)

$0.00 Lump Sum 0 $0.00 $0.00 Lump Sum 0 $0.00 subtotal $0.00 Drilling (Non-Conventional)

$0.00 Lump Sum 0 $0.00 $0.00 Lump Sum 0 $0.00 subtotal $0.00 Mobile Laboratory

$0.00 Lump Sum 0 $0.00 subtotal $0.00

Surveying $0.00 Lump Sum 0 $0.00 subtotal $0.00

IDW

$0.00 Lump Sum 0 $0.00 $0.00 Lump Sum 0 $0.00 subtotal $0.00

Utilities $0.00 Month 0 $0.00 $0.00 Month 0 $0.00 subtotal $0.00

Other none $0.00 Lump 0 $0.00 None $0.00 Month 0 $0.00 None $0.00 Month 0 $0.00 None $0.00 Month 0 $0.00 subtotal $0.00

TOTAL SUBCONTRACTOR (SERVICES) $0.00

Formatting and finalize SRCR

GIS figure development for SRCR

SRCR Technical preparation, oversight and Senior Review

SRCR preparation and sign/seal as Florida-licensed P.G.

SL-0A13X_CEF_rev 8/12/2021 Page 1 of 2 Subtask 3

Stringer, Brandie

From: Teresa Fischer <TFischer@Geosyntec.com> Sent: Wednesday, August 4, 2021 12:19 PM To: Stringer, Brandie Cc: Phillips, Dave M.; Blaine Dawson Subject: Northeast Florida State Hospital (NEFSH), ERIC_ 6136 - Work Plan and LOE for a Site Rehabilitation

Closure Report (SRCR), dated August 4, 2021 Attachments: NEFSH SRCR CEF-LOE 08042021.xlsx; Invoice Schedule_NEFSH_AOC 4_08042021.xlsx

Follow Up Flag: Follow up Flag Status: Flagged

Brandie:

Geosyntec has prepared this scope of work and proposed level of effort (LOE) to develop and submit a Site Rehabilitation Completion Report (SRCR) for Area of Concern (AOC) 4 located at the Northeast Florida State Hospital (NEFSH) in Macclenny, Baker County, Florida.

This LOE was prepared as a follow‐up to the Supplemental Site Investigation Report submitted by Geosyntec on June 11, 2021. The Supplemental Site Investigation Report recommended closure under Risk Management Option Level 1 (RMO

1) per Chapter 62‐780.680(1), Florida Administrative Code (FAC) for AOC 4.

A Deliverable and Invoice Schedule are also attached for your reference. The detailed subtask breakdowns for the attached LOE are provided below.

Subtask 1 – Project Management

Subtask 2 – LOE Preparation – This subtask includes developing a scope of work and preparing the attached LOE for the

FDEP.

Subtask 3 – SRCR Preparation – This subtask includes costs associated with the preparation of an SRCR, which includes a Site narrative, conclusion, and the recommendation for issuance of a Site Rehabilitation Completion Order (SRCO) for AOC 4. The SRCR will also include table(s) summarizing monitoring well construction details and laboratory data as well as figures showing the site layout, area land use, sampling locations, and pertinent analytical results from historical site investigation activities.

The SRCR will be formatted and contain appropriate content as outlined in the July 24, 2013 Memorandum from Bill Linn titled Format and Content of Site Rehabilitation Completion Reports and will be signed and sealed by a Florida‐licensed Professional Geologist. One electronic copy of the report will be provided in pdf format to the FDEP and to the facility upon FDEP’s approval.

Geosyntec appreciates this opportunity to work with the FDEP on this project. Please feel free to contact me if you have any questions or require any additional information.

Kind Regards, Teresa

Teresa A. Fischer, BCES Principal Scientist