CN-370000-HW556-DC03H.pdf

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

HW556

D000 NADC003H

Cardno, Inc.

Eric Meyers

850-245-8705Walsta Jean-Baptiste

ERIC_5232

Carriage Trade Dry Cleaners

38225 12th Avenue, Zephyrhills, Pasco County

Monitoring

This Task Assignment authorizes HSW to conduct annual groundwater monitoring and reporting in accordance with the HSW scope of work, cost estimate, bid documentation, and schedule received on February 9, 2021.

Groundwater Monitoring Report, IDW manifest, ADaPT/GIS update

05/14/2021

08/31/2021

$ 5,213.59 $ 0.00 $ 0.00 $ 0.00

$ 0.00

Walsta Jean-Baptiste Digitally signed by Walsta Jean-Baptiste Date: 2021.02.11 12:45:36 -05'00'

Walsta Jean-Baptiste Digitally signed by Walsta Jean-Baptiste Date: 2021.02.11 12:45:43 -05'00'

William E. Burns, Jr. Digitally signed by William E. Burns, Jr.

Date: 2021.02.11 14:25:49 -05'00'

Eric Meyers Digitally signed by Eric Meyers Date: 2021.02.11 14:43:43 -05'00'

$ 5,213.59

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

WCP TAFORM 01-2018

Contract Number:

Task Assignment #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

Groundwater Monitoring Report, IDW manifest, ADaPT/GIS update - Subtasks 2 and 3 05/14/2021

FDEP approval of Groundwater Monitoring Report, IDW manifest, ADaPT/GIS update - Subtasks 1-3 $ 5,213.59

$ 5,213.59

HW556

DC003H

FLORIDA DEPARTMENT OF

Environmental Protection

Bob Martinez Center

2600 Blair Stone Road Tallahassee, FL 32399-2400

Ron DeSantis Governor

Jeanette Nuñez

Lt. Governor

Noah Valenstein Secretary

Memorandum

TO: HW556 Contract File FROM: Walsta Jean-Baptiste, Project Manager SUBJECT: Carriage Trade Dry Cleaners HW556 DC003H DATE: February 11, 2021

This Task Assignment authorizes HSW to conduct annual groundwater monitoring at the Carriage Cleaners site in accordance with the HSW scope of work, cost estimate, bid documentation, and schedule received on February 9, 2021.

There were no changes to the proposed scope of work.

The cost related to this Task Assignment is $5,213.59 with 33 hours.

FDEP COST ESTI MATEContractor: CARDNO, Inc. / HSW Eng., Inc

Date: 2/11/2021

Task #: DC003H SubTask 1 Project Management SubTask 6

Site: Carriage Trade Dry Clean SubTask 2 Groundwater Sampling SubTask 7

Activity/Phase: Monitoring SubTask 3 Groundwater Monitoring Report SubTask 8

Project Manager: Steven Folsom SubTask 4 SubTask 9

SubTask 5 SubTask 10

Totals 1 2 3 4 5 6 7 8 9 10 Labor Rate Category

HSW Engineering, Inc.

$66.35 Project Manager 2 2.3

Principal 0 0 0 0 0 0 0 0 0 0 $66.35 Project Manager 2 0 2 0 0 0 0 0 0 0

Senior Geologist 0 0 0 0 0 0 0 0 0 0 Senior Engineer 0 0 0 0 0 0 0 0 0 0 Project Geologist 0 0 0 0 0 0 0 0 0 0

$45.20 Senior Engineer 13 1 12 0 0 0 0 0 0 0 Project Scientist 0 0 0 0 0 0 0 0 0 0

$28.43 Staff Engineer/Geologist 12 12 0 0 0 0 0 0 0 0 $25.97 Project Engineer/Geologist 0 0 0 0 0 0 0 0 0 0

Field Technician 0 0 0 0 0 0 0 0 0 0 $45.68 Senior GIS Specialist 1 0 1 0 0 0 0 0 0 0 $39.67 CADD Technician 3 0 3 0 0 0 0 0 0 0 $15.00 Project Assistant 0 0 0 0 0 0 0 0 0 0

Staff Engineer 0 0 0 0 0 0 0 0 0 0 $0.00 Surveyor (PLS) 0 0 0 0 0 0 0 0 0 0 $0.00 Survey Party chief 0 0 0 0 0 0 0 0 0 0 $0.00 Survey Crew 0 0 0 0 0 0 0 0 0 0 $0.00 Subsurface Utility Location (SUE) Tech 0 0 0 0 0 0 0 0 0 0 $0.00 0 0 0 0 0 0 0 0 0 0 $0.00 0 0 0 0 0 0 0 0 0 0 $0.00 0 0 0 0 0 0 0 0 0 0

Total Hours 33 2 13 18 0 0 0 0 0 0 0

HSW Engineering, Inc.

Direct Labor $1,379.42 $153.27 $386.36 $839.79 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Overhead 170.00% $2,345.01 $260.56 $656.81 $1,427.64 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Gen & Admin 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fringe 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Sub-Total Labor (HSW) $3,724.43 $413.83 $1,043.17 $2,267.43 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Total Labor $3,724.43 $413.83 $1,043.17 $2,267.43 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Other Direct Costs $68.97 $7.66 $19.32 $41.99 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

REV: 05/2015 CEF: CARDNO HSW Page 1

FDEP COST ESTI MATEContractor: CARDNO, Inc. / HSW Eng., Inc

Date: 2/11/2021

Task #: DC003H SubTask 1 Project Management SubTask 6

Site: Carriage Trade Dry Clean SubTask 2 Groundwater Sampling SubTask 7

Activity/Phase: Monitoring SubTask 3 Groundwater Monitoring Report SubTask 8

Project Manager: Steven Folsom SubTask 4 SubTask 9

SubTask 5 SubTask 10

Totals 1 2 3 4 5 6 7 8 9 10 Travel

Vehicle Rental $97.00 $97.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Mileage Costs $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Air Fare $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Per diem + Hotel $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Travel $97.00 $97.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor (Equipment Procurement) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Procurement Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor (Services Procurement) Drilling (Conventional) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Drilling (Non-conventional) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Mobile Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Surveying $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

IDW $115.00 $115.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Utilities $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor Subtotal $115.00 $115.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Handling Fee $11.50 $11.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $126.50 $126.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Laboratory Analytical Costs $462.00 $462.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fast Turnaround Charges $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Sample Shipping $63.00 $63.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Laboratory $525.00 $525.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Field Expenses Personal Protection $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Expendables $32.50 $32.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Drilling related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Analytical related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (IDW related) $58.20 $58.20 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Other) $208.55 $208.55 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Field Expenses $299.25 $299.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subtotal $4,841.15 $421.49 $2,110.24 $2,309.42 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Completion Fee $372.44 $41.38 $104.32 $226.74 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Total Estimated Cost $5,213.59 $462.87 $2,214.56 $2,536.16 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

REV: 05/2015 CEF: CARDNO HSW Page 2

SITE : Carriage Trade Dry Cleaners

FDEP NO: ERIC_5232

SUBTASK: 2 - Groundwater Sampling

DATE: 2/11/2021

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Senior Engineer NSB Technical Assistance 1

Staff Geologist KMT Mobilization, Demobilization 2 Sample 6 Monitoring Wells 10

TOTAL LABOR 13

TRAVEL TYPE RATE UNIT USEAGE Miles Free

Truck $97.00 day 1 $97.00

TOTAL VEHICLE $97.00

SUBCONTRACTOR

Equipment Procurement

NAME PURPOSE COST UNIT USEAGE

Services Procurement

NAME PURPOSE COST UNIT USEAGE

Petrotech SE IDW Disposal $115.00 Drum 1 $115.00

TOTAL SUBS $115.00

LABORATORY

PARAMETER RATE # SAMPLES #QAQC

Halocarbons (aqueous) EPA 8260 $66.00 6 1 $462.00 Sample Shipment/Preparation Small (0 to 25 lbs), Overnight $63.00 1 $63.00

TOTAL LAB $525.00

FIELD EXPENSES ITEM RATE UNIT USEAGE TOTALS

Field Equipment

Drum $58.20 Drum 1 $58.20 Shallow Groundwater Sampling Kit $208.55 day 1 $208.55

Sub-Total $266.75

Expendables $32.50 day 1 $32.50 Sub-Total $32.50

TOTAL EQUIPMENT $299.25

SITE : Carriage Trade Dry Cleaners

FDEP NO: ERIC_5232

SUBTASK: 3 - GW Monitoring Report

DATE: 2/11/2021

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Project Manager SDF Summary/Data Review 2

Project Engineer NSB IDW Coordination 1 GW Monitoring Report 10 Well Receptor Survey 1

CADD Technician BLA Report Graphics 3

Senior GIS Specialist CLW Data Management and GIS Table Development 1

TOTAL LABOR 18

TRAVEL TYPE RATE UNIT USEAGE Miles Free

TOTAL VEHICLE $0.00

SUBCONTRACTOR

Equipment Procurement

NAME PURPOSE COST UNIT USEAGE

Services Procurement

NAME PURPOSE COST UNIT USEAGE

TOTAL SUBS $0.00

FIELD EXPENSES ITEM RATE UNIT USEAGE TOTALS

Field Equipment

$0.00 $0.00

Sub-Total $0.00

Sub-Total $0.00

TOTAL EQUIPMENT $0.00

(813) 968-7722 ■ 15711 Mapledale Blvd., Suite B ■ Tampa, FL 33624 ■ www.hsweng.com Innovative Solutions Within Your Reach….

P:\1CB6 Cardno\1CB600201 Carriage Trade\01 Proposals\DC003H_GW Mon 2021\GW Monitoring Proposal.Docx

February 9, 2021

Ms. Walsta Jean-Baptiste, P.G.

Florida Department of Environmental Protection Hazardous Waste Cleanup Section 2600 Blair Stone Road, MS 4520 Tallahassee, FL 32399-2400

Re: Task Assignment Request – Annual Groundwater Monitoring Carriage Trade Dry Cleaners 38225 12th Avenue, Zephyrhills, FL

ERIC_5232

Dear Walsta:

HSW Consulting, LLC (HSW) is pleased to submit this Task Assignment Request for Annual Groundwater Monitoring Activities at the Carriage Trade Dry Cleaners Site. Attached herein are the proposed Level of Effort/Cost Estimate Forms, and Implementation Schedule. The scope of work, proposed deliverables, and deliverable schedule are summarized below.

The proposed scope of work associated with this Task Assignment Request includes the following elements:

HSW will sample six selected monitoring wells (MW002, MW03D, MW04D, MW006, MW007D, and MW008) approximately twelve months from the prior monitoring event (approximately March 2021);

HSW will arrange for disposal of investigation-derived waste (IDW) generated during the sampling event;

HSW will review available Water Management District and Florida Department of Health well construction permitting databases to identify any recently installed potable wells in the vicinity (within ½ mile) of the Site, with physical verification of identified and accessible wells.

HSW will prepare and submit a Groundwater Monitoring Report to summarize the sampling results and provide recommendations for further courses of action;

Subtask 1: Project Management

Subtask 2: Completion of groundwater monitoring event with submittal of Groundwater Monitoring Report; submittal of GWMR, IDW manifest, updated GIS database sample tables, and all ADaPT deliverables

Deliverable Date: May 14, 2021

Carriage Trade Dry Cleaners Annual Groundwater Monitoring TA Request

HSW Consulting ■ www.hsweng.com 2 Innovative Solutions Within Your Reach….

Sincerely, HSW ENGINEERING, INC.

Nicholas S. Barnes, P.E.

Senior Engineer

Attachments: Level of Effort/Cost Estimate Forms

Subcontractor Quotations Figure

May 26, 2016

Nick Barnes HSW Enginering 15711 Mapledale Blvd Suite B Tampa Fl 33624 813-549-1016

RE: Drum disposal

Dear Nick:

Petrotech Southeast, Inc. would like to take this opportunity to thank you for your interest in our services. Per your request, please find our proposal for the services you require.

Description of work: Petrotech Southeast, Inc. proposes to provide the equipment and personnel to remove IDW drums from site in Zephryhills, Fl. Drums must be placed on hard surface, IE concrete or asphalt. Additional loading charge may apply. All non-hazardous waste material will be recycled and/or disposed of according to Florida’s Department of Environmental Protection’s regulations. All rates are based upon standard working hours 8 AM to 5 PM Monday through Friday.

Product / Service Unit Type Unit Price Non Haz,IDW Liquid / Solid drum

Disposal with Trans and fuel charge Per Drum $115.00

With approved Analytical / profile.

Estimate is for budgetary purpose only actual Quantities invoiced.

Payment Terms: Net 30 days.

All other Petrotech Southeast, Inc. standard terms and conditions shall apply. Any applicable taxes and fuel surcharges shall be invoiced accordingly. Quoted pricing is good for 90 days.

If you have any questions regarding this service agreement, please do not hesitate to call me 407-656-8114. Otherwise, please return a signed copy.

Best regards, PETROTECH SOUTHEAST, INC. HSW Engineering

Mike Anderson Mike Anderson Date Signature Date Sales Title

Price confirmed

Pricing confirmed nbarnes Line nbarnes Text Box