CN-370000-HW557-DC01ACO6.pdf
PDF 144 KB Posted
- Contract number
- HW557
- Issued by
- Florida
About this file
This document is a Task Assignment Notification Change Order Form for the Florida Department of Environmental Protection (FDEP). The change order, designated as DC001A-6, is issued under DEP Contract No. HW557 with contractor Arcadis U.S., Inc. The contract manager is Theresa C. Pepe, and the contractor representative is William Vogelsong. The task assignment applies to multiple sites under FDEP's jurisdiction.
Change Order No. 6 extends the task completion date by six months to align with the contract expiration date of June 22, 2021. The original task completion date was December 23, 2015, with the completion date prior to this change order set at December 23, 2020. There is no modification to the fixed price task amount of $16,591.63, which remains unchanged. The deliverables include a Critical Response Action/Summary and documentation of site activities related to Tropical Storm Isaac, Tropical Storm Erika, Hurricane Irma, Hurricane Readiness and Property Inventory for seven sites, and Hurricane Dorian. The invoice schedule specifies that Arcadis may invoice upon FDEP approval of each deliverable, with amounts ranging from $2,476.69 to $3,343.00 per deliverable, totaling $16,591.63. The change order was executed on December 11, 2020, and represents a time extension only with no cost increase to the contract.
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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
HW557
6DC001A
Arcadis U.S., Inc.
William Vogelsong
(850) 245-8705Theresa C. Pepe
Multiple
Multiple
This change order adds a six month time extension to match the contract expiration date.
Critical Response Action/Summary 06/22/2021
$ 2,500.00 $ 0.00 $ 0.00 $ 0.00
$ 16,591.63 $ 0.00 $ 0.00 $ 0.00 $ 16,591.63
$ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00
$ 16,591.63
12/23/2015
12/23/2020
6 months
06/22/2021
Theresa C Pepe Digitally signed by Theresa C Pepe Date: 2020.12.11 15:08:06 -05'00'
Theresa C Pepe Digitally signed by Theresa C Pepe Date: 2020.12.11 15:08:18 -05'00'
William E. Burns, Jr. Digitally signed by William E. Burns, Jr.
Date: 2020.12.11 15:29:20 -05'00'
William D. Vogelsong Digitally signed by William D. Vogelsong Date: 2020.12.11 18:05:52 -05'00'
$ 16,591.63 $ 0.00 $ 0.00 $ 0.00
$ 2,500.00
Pepe_T Cross-Out
Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment
Contract Number: HW557 Task Assignment #: DC001A
Change Order #: 6
Deliverables:
Deliverable Deliverable Due Date
Critical Response Action/Summary 22-Jun-21
Documentation of Site Activities - Tropical Storm Isaac 30-Sep-12
Documentation of Site Activities - Tropical Storm Erika 28-Sep-15
Documentation of Site Activities - Hurricane Irma 29-Sep-17 Documentation of Hurricane Readiness and Property Inventory -seven sites 31-May-18
Documentation of Site Activities - Hurricane Dorian 13-Sep-19
Invoice Schedule:
Requirements for Invoice Submittal Amount to be Invoiced
FDEP approval of Critical Response Action/Summary $2,500.00
FDEP approval of completed site activities associated with Tropical Storm Isaac Previously Invoiced
$3,287.49
FDEP approval of completed site activities associated with Tropical Storm Erika Previously Invoiced
$2,497.99
FDEP approval of completed site activities associated with Hurricane Irma Previously Invoiced
$3,343.00
FDEP approval of Documentation of Hurricane Readiness and Property Inventory - seven sites Previously Invoiced
$2,486.46
FDEP approval of completed site activities associated with Hurricane Dorian $2,476.69
TOTAL COST $16,591.63
BWC TAFORM 01_18
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: Negotiation File Critical Response Task Assignment Multiple Sites FROM: Theresa C. Pepe, Project Manager SUBJECT: Task Assignment Change Order DC001A-6 (HW557) DATE: December 11, 2020
Task Assignment Change Order DC001A-6 adds a six-month time extension to match the end date of the HW557 contract.
Arcadis may invoice according to the attached schedule. There is no cost change for this task assignment.
| 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 .