CN-370000-HW551-DC01A-10.pdf
PDF 817 KB Posted
- Contract number
- HW551
- Issued by
- Florida
About this file
This is a Task Assignment Notification Change Order Form (Change Order No. 10) for DEP Contract No. HW551, issued by the Florida Department of Environmental Protection (DEP). The contractor is AECOM Technical Services, Inc. (AECOM), represented by Mark Rasberry. The DEP Contract Manager is Ben Grubbs. The change order was digitally signed on December 15, 2020, by Benjamin Grubbs (DEP Task Manager and DEP Contract Manager), William E. Burns, Jr. (Contractual Authority), and Mark Rasberry (Contractor Representative).
This change order authorizes a time extension for Task Assignment DC001A to keep the task open for critical response activities if warranted. The final deliverable is "Documentation of Completed Site Activities" with a due date of June 28, 2021. The task involves eight deliverables related to site visit documentation, damage assessments from various weather events (Tropical Storms Isaac and Erika, Hurricanes Irma and Dorian), property inventory, and hurricane readiness. The original task amount was $2,500.00; the task amount prior to this change order was $9,934.91; and there is no net increase or decrease in the task amount with this change order, maintaining a total of $9,934.91 on a fixed-price basis. The original task completion date was December 28, 2015, extended to December 28, 2020, and further extended by six months to June 28, 2021. All previously invoiced deliverables total $7,434.91, with the final deliverable invoiced at $2,500.00 upon FDEP approval.
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Text version
DEP CONTRACT NO.
Task Assignment #: Change Order No.:
Contractor Name:
Contractor Representative:
DEP Contract Manager: Phone #:
Site Name:
Site ID / Facility ID::
Description of Change [use additional pages if necessary]:
The Deliverable and Invoice Schedule is attached.
Final Deliverable:
TASK ASSIGNMENT TYPE AND NOT TO EXCEED AMOUNTS:
Cost Reimbursement Fixed Fee
Original Task Amount
Task Amount Prior to this Change Order Net Increase/decrease in task amount Task amount with all change orders $0.00 $0.00 $0.00 $0.00
Original Task Completion Date:
Completion Date Prior to this Change:
Net Increase/Decrease in Task Period:
Completion Date with all Change Orders:
DEP Task Manager:
DEP Contract Manager:
Contractual Authority:
Contractor Representative:
CC: Procurement Section (MS 93) Section Representative ________
FIXED PRICE
TASK ASSIGNMENT NOTIFICATION CHANGE ORDER FORM
ITEM
$0.00
$0.00
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).
Final Deliverable Due Date:
$0.00
$0.00
CHANGE IN TASK TIME
FEE SCHEDULE
COST PLUS FIXED FEE
TOTAL
WCP TAFORM 01_18
HW551
10DC001A
AECOM Technical Services, Inc. (AECOM)
Mark Rasberry
(850) 245-8992Ben Grubbs
NA
NA
This Task Assignment Change Order authorizes a time extension to keep this Task Assignment open should critical response activities be warranted.
Documentation of Completed Site Activities 06/28/2021
$ 2,500.00 $ 0.00 $ 0.00 $ 0.00
$ 9,934.91 $ 0.00 $ 0.00 $ 0.00 $ 9,934.91
$ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00
$ 9,934.91
12/28/2015
12/28/2020
6 months
06/28/2021
Benjamin Grubbs Digitally signed by Benjamin Grubbs Date: 2020.12.15 08:47:13 -05'00'
Benjamin Grubbs Digitally signed by Benjamin Grubbs Date: 2020.12.15 08:47:25 -05'00'
William E. Burns, Jr. Digitally signed by William E. Burns, Jr.
Date: 2020.12.15 11:17:29 -05'00'
Digitally signed by Rasberry, Mark DN: cn=Rasberry, Mark, ou=USORL3 Date: 2020.12.15 14:56:17 -05'00'
Rasberry, Mark
$ 9,934.91 $ 0.00 $ 0.00 $ 0.00
$ 2,500.00
Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment
Contract Number: HW551 Task Assignment #: DC001A
Change Order #: 10
Deliverables:
Deliverable Deliverable Due Date Documentation of Site Visit Complete
Documentation of Casual Cleaners vault damage Complete
Documentation of Tropical Storm Isaac preparation Complete
Documentation of Tropical Storm Erika preparation Complete
Documentation of Hurricane Irma damage to Classic French Cleaners
Complete
Documentation of Property Inventory and Hurricane Readiness Complete
Documentation of Hurricane Dorian response Complete
Documentation of Completed Site Activities 28-Jun-21
Invoice Schedule:
Requirements for Invoice Submittal Amount to be Invoiced FDEP approval of Documentation of Site Visit *Previously Invoiced* $1,196.68
FDEP approval of Documentation of Casual Cleaners vault damage *Previously Invoiced*
$547.43
FDEP approval of Documentation of Tropical Storm Isaac preparation *Previously Invoiced*
$926.18
FDEP approval of Documentation of Tropical Storm Erika preparation *Previously Invoiced*
$640.83
FDEP approval of Documentation of Hurricane Irma damage to Classic French Cleaners *Previously Invoiced*
$1,162.87
FDEP approval of Documentation of Property Inventory and Hurricane Readiness *Previously Invoiced*
$1,759.71
FDEP approval of Documentation of Hurricane Dorian response *Previously Invoiced* $1,201.21
FDEP approval of Documentation of Completed Site Activities $2,500.00
TOTAL COST $9,934.91
BWC TAFORM 01_18
9/20/19
| Task Assignment CHANGE ORDER |
| BWC Task Assignment Change Order Form (Rev 02-17).pdf |
| Task Assignment CHANGE ORDER |
| BWC Task Assignment Form - Page 2 (Rev 08_10) - Rev 1.pdf |
| Deliverable & Invoice Schedule |
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