CN-370000-HW553-CSS17A-1.pdf
PDF 65 KB Posted
- Contract number
- HW553
- Issued by
- Florida
About this file
This is a Task Assignment Notification Change Order Form (Change Order No. 1) issued by the Florida Department of Environmental Protection (FDEP) for DEP Contract No. HW553, Task Assignment CSS-17A. The contractor is Ecology and Environment, represented by Stephen Elliot, with Carrie L. Kruchell, P.G. serving as the FDEP Contract Manager. The work pertains to site inspection services at the Pensacola Iron Triangle facility (Site ID COM_303255).
The change order extends the original task completion date from November 2, 2018 to February 1, 2019 and adjusts the final deliverable due date to December 3, 2018. The task is structured as a fixed-price assignment with a total not-to-exceed amount of $22,810.83, representing no net change in cost. Deliverables include a Site Inspection Work Plan with Health and Safety Plan (due 06/18/2018 for $3,589.92), Site Inspection Field Notes with XRF logs and sampling documentation (due 07/09/2018 for $11,722.24), and a Final Site Inspection Report (due 12/03/2018 for $7,498.67). Invoice payments are conditioned upon FDEP approval of each deliverable phase. All signatures were obtained between October 29 and October 31, 2018.
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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
HW553
1CSS-17A
Ecology and Environment
Stephen Elliot Phone #: 850-435-8925
850-245-8765Carrie L. Kruchell, P.G.
Pensacola Iron Triangle
COM_303255
Per Ecology and Environment's October 24th change order request, this change order will extend the original task completion date to 2/01/2019 and change the final deliverable due date to 12/3/2018.
Site Inspection Report 12/03/2018
$ 22,810.83 $ 0.00 $ 0.00 $ 0.00
$ 22,810.83 $ 0.00 $ 0.00 $ 0.00 $ 22,810.83
$ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00
$ 22,810.83
11/02/2018
11/02/2018
02/01/2019
Padraic Conner Digitally signed by Padraic Conner Date: 2018.10.29 13:17:11 -04'00'
Carrie Kruchell Digitally signed by Carrie Kruchell Date: 2018.10.29 14:25:45 -04'00'
Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2018.10.30 08:24:37 -04'00'
Steven Elliott Digitally signed by Steven Elliott Date: 2018.10.31 11:00:13 -04'00'
$ 22,810.83 $ 0.00 $ 0.00 $ 0.00
$ 22,810.83
Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment
BWC TAFORM 2/03
Contract Number:
Task Assignment #:
Change Order #:
Deliverables:
Deliverable Deliverable Due Date
Invoice Schedule:
Requirements for Invoice Submittal Amount to be Invoiced
TOTAL COST
HW553
CSS-17A
$ 22,810.83
SI Work Plan, email confirmation of USEPA Scribe Tables & Health and Safety Plan
Site Inspection Field Notes, XRF logs, Soil and groundwater sampling logs and completed chain of custody
Final Site Inspection Report
FDEP Approval of the Site Inspection Work Plan and HASP (Subtask 2)
FDEP Approval of Final Site Inspection Report (Subtask 1 and 4)
FDEP approval of Sile Inspection Field Notes, XRF logs, soil and groundwater sampling logs and completed chain of custody (Subtask 3)
06/18/2018
07/09/2018
12/03/2018
$ 11,722.24
$ 3,589.92
$ 7,498.67
| 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 |
File details come from the government source that posted it. Updated .