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

HW552

D000 N/ADC036B

Professional Service Industries, Inc. (PSI)

Nana Westmark

850-245-8928Killian Talley

ERIC_5243

Former Wash Bowl

7104 Highway 52, Port Richey, Pasco

Site Assessment

This Task Assignment authorizes PSI to conduct site assessment in accordance with the April 7, 2020 scope of work, cost estimate, bid documentation, and approved January 2020 Site Assessment Work Plan.

Site Assessment Report, ADaPT/GIS Update, and Final IDW Manifest

03/05/2021

06/25/2021

$ 89,760.56 $ 0.00 $ 0.00 $ 0.00

$ 0.00

Killian Talley Digitally signed by Killian Talley Date: 2020.09.15 14:12:21 -04'00'

Killian Talley Digitally signed by Killian Talley Date: 2020.09.15 14:12:33 -04'00'

Digitally signed by Jennifer Farrell Date: 2020.09.15 16:38:38 -04'00'

Nana Westmark Digitally signed by Nana Westmark Date: 2020.09.16 11:53:15 -04'00'

$ 89,760.56

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

Subtasks 2-4: Submittal of field documentation for assessment activities including sewer investigation, DPT well installation, and MAGs construction & testing 12/18/2020

Subtasks 5-6: Submittal of field documentation for DPT activities, monitoring well installation, and monitoring well sampling 01/29/2021

Subtasks 1, 7 &8: Submittal of Site Assessment Report, ADaPT/GIS Update, and Final IDW Manifest 03/05/2021

Subtasks 2-4: FDEP receipt and approval of field documentation for assessment activities including sewer investigation, DPT well installation, and MAGs construction & testing

$ 35,532.18

Subtasks 5-6: FDEP receipt and approval of field documentation for DPT activities, monitoring well installation, and monitoring well sampling $ 36,018.33

Subtasks 1, 7 & 8: FDEP receipt and approval of Site Assessment Report, ADaPT/GIS Update, and Final IDW Manifest $ 18,210.05

$ 89,760.56

HW552

DC036B

Florida Department of Memorandum Environmental Protection

Printed on recycled paper.

To: HW552 Contract Negotiation File Former Wash Bowl Port Richey, Pasco County

ERIC_ 5243

From: Killian Talley, Project Manager Date: September 15, 2020 Subject: Negotiation Summary

HW550 DC036B

Task Assignment HW552 DC036B is for PSI to oversee the implementation of the approved Site Assessment Work Plan.

Subtask 1: Project Management An automatic calculation based upon total direct labor hours determines the labor hours within this subtask.

Subtask 2: Site Review Subtask includes costs and labor for assessment preparation elements including tenant communications, utility locations, and sewer investigation activities. Utility locate and sewer line investigation will be completed by GeoTek and the Drain Team respectively.

Subtask 3: Lith Boring, MW Sampling, MAGs Construction Subtask includes cost and labor associated with preliminary assessment activities including a lithological boring, soil sampling, installation of three shallow monitoring wells, and construction of MAGs wells. Following installation and construction activities groundwater and soil samples will be sent to the lab and analyzed by EPA Method 8260. Direct push technology will be provided by PDS who has been selected as the lowest responsive and responsible bidder.

Subtask 4: MAGS Testing Subtask includes cost and labor associated with testing of the previously construct MAGs wells to assist in identifying potential source areas and extent of soil impacts. On vapor sample will be collected at each MAGs well for submittal of VOC analysis by Method TO-15.

Subtask 5: Direct Push/Mobile Lab GW Sampling Subtask includes cost and labor related to groundwater direct push investigation. Nine (9) borings will be completed to collect groundwater samples for VOH analysis by a mobile lab on site. Sampling locations may be modified based on previous assessment data, depth to refusal, and in field data decisions. Drilling services and mobile lab will be performed by Huss & ALF respectively who have been selected due to their lowest responsive and responsible bids.

Former Wash Bowl Page Two

Subtask 6: MW Construction/Sampling Subtask includes labor and related costs for the installation additional site monitoring wells. Well installation will be used to augment previous groundwater sampling and fill data gaps. Following installation wells will be samples via EPA Method 8260. Drilling services will be performed by Huss Drilling who has been selected as the lowest responsive and responsible bidder.

Subtask 7: Site Assessment Report Subtask will include labor related to evaluation of site assessment data and generation of a Site Assessment Report for Department review in accordance with Chapter 62-780, FAC. The report will also include conclusions and recommendations for future site work.

Subtask 8: IDW Disposal This subtask includes costs and labor related to the transport and disposal of investigative derived waste generated during assessment and monitoring activities. Clark Environmental has been selected as the lowest responsive and responsible bidder for this task.

The FDEP Project Manager agrees to the scope of work and final cost associated with this Task Assignment. The final cost for this Task Assignment is $89,760.56 with 387 labor hours.

PSI may invoice following the schedule established in the Deliverables and Invoice Schedule Attachment, which accompanies the Task Assignment Notification Form.

LEVEL OF EFFORT/EXPENSE WORKSHEET

SITE : Wash Bowl SUBTASK: Site Review

DATE: 4/7/20

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Sr. Consultant Review documents 0.5 (G. Lassi, PG) Site visit , meet with property owner representative and tenant 5

Sr. Proj Mgr (survey) Survey- proj research, benchmarks, pre and post calculations 5 (F. Ammerman)

Sr. Proj Mgr Project preparation 1 (C. Browning, PG) Coordinate GPR and sewer line inspection, schedule, notices 4

Travel (roundtrip) 3 Contact utility for municipal locate 0.5 Oversite of GPR and sewer line inspection 8

2 man Survey Crew travel, specific purpose survey of sampling areas on and offsite 30 with GPS

Sr. Draftsman prepare survey and site plan drawings 8 (B. Fisher)

TOTAL LABOR 65

EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS

Site Reconnaissance Kit $81.48 day 1 $81.48

TOTAL EQUIPMENT $81.48

VEHICLE TYPE RATE UNIT USEAGE

Equipment Van / Truck $97.00 day 2 $194.00 Surveyor Truck $97.00 day 2 $194.00

TOTAL VEHICLE $388.00

PER DIEM STAFF RATE UNIT USEAGE

TOTAL PER DIEM $0.00

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC

TOTAL LAB $0.00

SUBCONTRACTOR COSTS

NAME PURPOSE UNIT COST

GeoTek Utility locate 1 $750 $750.00 Drainteam Sewer Line Inspection 1 $630 $630.00

TOTAL $1,380.00

HW552_DC036B_CEFLOE.xlsx Page 1

LEVEL OF EFFORT/EXPENSE WORKSHEET

SITE : Wash Bowl SUBTASK: IDW disposal

DATE: 4/7/2020

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Sr. Consultant profile waste, secure signed manifest 2

TOTAL LABOR 2

EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS

TOTAL EQUIPMENT $0.00

VEHICLE TYPE RATE UNIT USEAGE

TOTAL VEHICLE $0.00

PER DIEM STAFF RATE UNIT USEAGE

TOTAL PER DIEM $0.00

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC

TOTAL LAB $0.00

SUBCONTRACTOR COSTS

NAME PURPOSE UNIT COST

Clark IDW soil 6 $110.00 $660.00

IDW water 4 $90.00 $360.00 $0.00

TOTAL $1,020.00

HW552_DC036B_CEFLOE.xlsx Page 2