CN-370000-HW552-DC03DCO4.pdf

This is a Task Assignment Notification Change Order Form for DEP Contract No. HW552, issued by the State of Florida Department of Environmental Protection. The document modifies Task Assignment DC003D, which is assigned to PSI Inc. under the contract. The task involves work at Brandywine Cleaners, identified by Site ID/Facility ID 649500628. Christopher Pellegrino serves as the DEP Contract Manager, and Nana Westmark represents the contractor.

The change order extends the task completion timeline by three weeks, moving the original completion date of 7/20/2013 to 8/9/2013. The deliverables consist of four subtasks: submittal and approval of monthly O&M data and logs for two quarters with a well abandonment letter (due 4/30/2013); submittal of a groundwater monitoring report with GIS and ADaPT deliverables and a semi-annual RASS report (due 4/30/2013); six months of paid utility invoices with a $240 handling fee (due 6/20/2013); and final paid utility invoices. The task amount remains fixed at $24,773.10 prior to this change order, with no net increase or decrease in the task amount. The total cost breakdown includes $24,773.10 in fixed price, $2,250.00 in cost reimbursement, resulting in a total task amount of $27,023.10. The change order is solely for time extension to allow PSI Inc. to complete invoicing requirements.