Task Assignment Notification Change Order Form - Contract HW552

This is a Task Assignment Notification Change Order Form for Florida Department of Environmental Protection Contract HW552, issued to PSI, Inc. (Professional Service Industries, Inc.) for work at the Jay Lee Cleaners facility (ID 67-9502052) in Washington County. The change order, designated as DC005I Change Order No. 1, was executed in June 2015 with signatures from Emily Hladky (DEP Contract Manager), Nana Westmark (Contractor Representative), and the Contractual Authority. The work involves operation and maintenance of the remedial system at this contaminated site.

The change order extends the original task assignment by an additional 90 days and adds a third quarter of operations and maintenance (O&M) and utility costs. The original task amount of $29,793.50 increases by a net of $10,915.91 to a total task amount of $40,709.41 with all change orders. Costs are structured as Cost Plus Fixed Fee, with a cost reimbursement of $6,210.00 and no fixed fee component. The utility costs are the only portion designated as Cost Plus Fixed Fee. The deliverables include three months of system data (laboratory analytical data, vacuum data, and PID sampling with O&M checklists), a groundwater monitoring/RASS report, and nine months of paid utility invoices for electrical and telephone services. The completion date extended from September 30, 2015 to December 29, 2015. Total cost breakdown includes $27,308.54 for monthly O&M data and logs, $6,830.87 for groundwater monitoring reports, and $6,570.00 for utility expenses, with a utilities handling fee of $360.00.