CN-370000-HW557-CSS1B.pdf

BWC TAFORM 03/03

DEP CONTRACT NO. HW557

Task Assignment #: CSS-1B Module #: CERSI Grant #: CER15 Contractor Name:

Contractor Representative:

DEP Contract Manager: Phone #: 850-245-8986 DEP Site #:

Site Name:

Address(Street, City, County):

Task Description [use additional pages if necessary]:

Final Deliverable:

Final Deliverable Due Date:

4/28/2016

TASK ASSIGNMENT TYPE AND NOT TO EXCEED AMOUNTS:

FIXED FEE

$0.00 $0.00

RETAINAGE: NA

TOTAL TASK ASSIGNMENT VALUE: $20,409.41

DEP Task Manager: Date: 1/6/2016

DEP Contract Manager: Date: 1/6/2016

Contractual Authority: Date: 1/6/2016

Contractor Representative: Date:

CC: Procurement Section (MS 93)

COST REIMBURSEMENT

FIXED PRICE FEE SCHEDULE

Site Inspection Fieldnotes

Period of Performance:

Execution of Task Assignment through:

COST PLUS FIXED FEE

$20,409.41 $0.00 for Peter Cornais

5190 NW 10th Terrace Ft. Lauderdale, Broward County, Florida

As per proposal dated January 5, 2016, this task assignment is issued for: Project Management (Sub Task 1), Logistics (Sub Task 2) and Site Inspection (SI) Field Work (Sub Task 3). Note that SubTask 4 (SI Report) will be tasked at a later date.

1/29/2016

Allied Decals of Florida

TASK ASSIGNMENT NOTIFICATION FORM

Arcadis U.S., Inc.

Brooks Baldwin Ferda Yilmaz

COM # 52897

JLAppleg Stamp

JLAppleg Typewritten Text 1/06/16

JLAppleg Typewritten Text

JLAppleg Typewritten Text

JLAppleg Typewritten Text

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

BWC TAFORM 2/03

Contract Number: HW557 Task Assignment #: CSS-1B

Deliverables:

Deliverable Deliverable Due Date

Site Inspection Fieldnotes 29-Jan-16

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

Site Inspection Fieldnotes for Sub Tasks 1-3 $20,409.41

TOTAL COST $20,409.41