CN-370000-HW560-CS18ACO1.pdf

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Master Agreement FL|HW560|10644db8faa9279934cd6b08f1138598
Contract number
HW560
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Florida

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This document is a Task Assignment Notification Change Order Form for Florida Department of Environmental Protection (FDEP) Contract No. HW560, executed between FDEP and contractor Tetra Tech, Inc. The change order modifies Task Assignment CSS-18A for a Site Inspection project at QMS Circuits located at 40 Hill Avenue, Fort Walton Beach, Okaloosa County, Florida. Key personnel include Gerald Walker, P.G., as Contractor Representative, and Carrie L. Kruchell, P.G., as DEP Contract Manager. The change order was signed by authorized representatives including Padraic Conner (FDEP Task Manager), Carrie Kruchell (DEP Contract Manager), and Teresa Booeshaghi (Contractual Authority) in October 2018.

Change Order No. 1 reduces the original task assignment cost by $3,631.35 (approximately 10.7 percent), bringing the total project cost from $33,878.00 to $30,246.65. The cost reduction resulted from early project completion and reduced resource consumption, including 8 fewer labor hours, reduction of 3 hand augers due to completing only 6 borings instead of 7, one-day reduction in vehicle rental, one-day reduction in hotel costs for two personnel, and a $30 decrease in drilling costs. The deliverables remain unchanged: Site Inspection Work Plan and HASP, field notes with monitoring well construction logs and sampling logs, and a Final Site Inspection Report. Invoice milestones are FDEP approval of the Work Plan and HASP ($3,998.79), approval of field notes and sampling logs ($18,409.52), and approval of the Final Site Inspection Report ($7,838.34). The original completion date of December 28, 2018, was extended by 25 days to January 22, 2019, to accommodate a hurricane shutdown and allow time for laboratory data processing.

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TO: Tetra Tech, Inc., HW560 Contract File CERCLA Site Screening

FROM: Carrie L. Kruchell, P.G., Contract Manager

DATE: October 16, 2018

SUBJECT: Negotiation Summary – Task Assignment Change Order (TACO) CSS-

18A-1 QMS Circuits, COM_6123, Fort Walton Beach, Okaloosa Co. Site Inspection (SI)

This Change Order (CSS-18A-1) for the QMS Circuits SI reduces costs due to early completion of the project and reduced use of equipment and materials.

Subtask 1: Project Management A reduction in project management hours occurred due to the change in labor hours under Subtask 3. This results in a decrease in this subtask cost in the amount of ($336.02).

Subtask 2: SI Work Plan, and Health and Safety Plan There was no change in the cost of this subtask.

Subtask 3: Well Installation, Soil and Groundwater Sampling The reduction in days on site resulted in several changes to Subtask 3.

They include the following:

1. Fewer labor hours. The accelerated schedule resulted in 8 fewer hours under this subtask for all three individuals participating in the field subtask.

2. Reduction in equipment. Under the original task assignment, there were to be 7 hand auger borings, however only 6 were advanced. This resulted in usage of 3 fewer augers.

3. Decrease in vehicle. Van rental was reduced by 1 day, from 4 to 3.

4. Hotel was reduced by 1 day for two personnel.

5. Drilling cost decreased from the proposed amount by $30. This was due to fewer materials used in well installation.

This resulted in a total reduction of Subtask 3 in the amount of ($3,295.35).

Subtask 4: SI Report There was no change in the cost of this subtask.

Summary The original Task Assignment totaled $33,870.00. This Change Order reduces the cost by $3,631.35. The revised total project cost would be $30,246.65.

FDEP COST ESTIMATE

Contractor: Tetra Tech, Inc.

Date: October 3, 2018

Task #: HW560 TA CSS-18A CO SubTask 1 Project Management

Site: QMS Circuits SubTask 2 Work Plan & HASP

Activity/Phase: Site Inspection and Report SubTask 3 Soil Sampling,Well Installation,Groundwater Sampli

Project Manager: P. Conner-FDEP/G. Walk SubTask 4 Report

SubTask 5

Totals 1 2 3 4 5 Labor Rate Category

$59.25 Project Manager (GW) 14 13.6 $55.00 Scientist V (RH) 38 2 32 4 0 $30.32 Scientist II (QK) 34 8 26 0 0 $40.62 Scientist IV (BO) 0 0 0 0 0 $24.88 Engineer I (MQ) 114 32 32 50 0 $35.25 Staff GIS Specialist (JM) 8 2 0 6 0 $23.06 Project Assistant (LC) 8 4 0 4 0

Total Hours 216 14 48 90 64 0

Direct Labor $7,226.64 $802.96 $1,311.46 $3,344.48 $1,767.74 $0.00

Overhead 143.00% $10,334.10 $1,148.23 $1,875.39 $4,782.61 $2,527.87 $0.00 Gen & Admin 12.20% $2,142.41 $238.05 $388.80 $991.50 $524.06 $0.00 Fringe 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Labor $19,703.15 $2,189.24 $3,575.65 $9,118.59 $4,819.67 $0.00

Other Direct Costs $361.33 $40.15 $65.57 $167.22 $88.39 $0.00 Travel

Vehicle Rental $876.00 $0.00 $876.00 $0.00 $0.00 Mileage Costs $0.00 $0.00 $0.00 $0.00 $0.00 Air Fare $381.00 $0.00 $381.00 $0.00 $0.00 Per diem + Hotel $1,092.00 $0.00 $1,092.00 $0.00 $0.00 Total Travel $2,349.00 $0.00 $2,349.00 $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

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

Subcontractor (Services Procurement) Transportation & Disposal $0.00 $0.00 $0.00 $0.00 $0.00 Drilling and Well Installation $2,445.00 $0.00 $2,445.00 $0.00 $0.00 Mobile Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 Surveying $0.00 $0.00 $0.00 $0.00 $0.00

IDW $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

Subcontractor Subtotal $2,445.00 $0.00 $2,445.00 $0.00 $0.00 Handling Fee $244.50 $0.00 $244.50 $0.00 $0.00 Total Subcontractor Cost $2,689.50 $0.00 $2,689.50 $0.00 $0.00

Laboratory Sample Containers $685.00 $0.00 $685.00 $0.00 $0.00 Encore Samplers $708.75 $0.00 $708.75 $0.00 $0.00 Sample Shipping $832.00 $0.00 $832.00 $0.00 $0.00 Total Laboratory $2,225.75 $0.00 $2,225.75 $0.00 $0.00

Field Expenses Hand Auger $148.50 $0.00 $148.50 $0.00 $0.00 Monitoring Well Installation Kit $184.30 $0.00 $184.30 $0.00 $0.00 Groundwater Sampling Kit $208.55 $0.00 $208.55 $0.00 $0.00 Expendables $65.00 $0.00 $65.00 $0.00 $0.00 Personal Protection (Level D) $84.00 $0.00 $84.00 $0.00 $0.00 Teflon Tubing (1/4 inch diameter) $175.50 $175.50 Ice for Samples $40.00 $40.00 Total Survey Station $41.75 $0.00 $41.75 $0.00 $0.00 Total Field Expenses $947.60 $0.00 $947.60 $0.00 $0.00

Subtotal $28,276.33 $2,229.39 $3,641.22 $17,497.66 $4,908.06 $0.00 Completion Fee $1,970.32 $218.92 $357.57 $911.86 $481.97 $0.00

Total Estimated Cost $30,246.65 $2,448.31 $3,998.79 $18,409.52 $5,390.03 $0.00

REV: 03/23/17 Page 1

Date: October 3, 2018

Task #: HW560 TA CSS-18A_CO SubTask 1 Project Management

Site: QMS Circuits SubTask 2 Work Plan & HASP

Activity/Phase: Site Inspection and Report Delta SubTask 3 Soil Sampling,Well Installation,Groundwater Sampli

Project Manager: P. Conner-FDEP/G. Walk SubTask 4 Report

SubTask 5

Totals 1 2 3 4 5 Labor Rate Category

$59.25 Project Manager (GW) -2 -1.9 $55.00 Scientist V (RH) -8 0 -8 0 0 $30.32 Scientist II (QK) -8 0 -8 0 0 $40.62 Scientist IV (BO) 0 0 0 0 0 $24.88 Engineer I (MQ) -8 0 -8 0 0 $35.25 Staff GIS Specialist (JM) 0 0 0 0 0 $23.06 Project Assistant (LC) 0 0 0 0 0

Total Hours -26 -2 0 -24 0 0

Direct Labor ($991.80) ($110.20) $0.00 ($881.60) $0.00 $0.00

Overhead 143.00% ($1,418.28) ($157.59) $0.00 ($1,260.69) $0.00 $0.00 Gen & Admin 12.20% ($294.03) ($32.67) $0.00 ($261.36) $0.00 $0.00 Fringe 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Labor ($2,704.11) ($300.46) $0.00 ($2,403.65) $0.00 $0.00

Other Direct Costs ($49.59) ($5.51) $0.00 ($44.08) $0.00 $0.00 Travel

Vehicle Rental ($97.00) $0.00 ($97.00) $0.00 $0.00 Mileage Costs $0.00 $0.00 $0.00 $0.00 $0.00 Air Fare $0.00 $0.00 $0.00 $0.00 $0.00 Per diem + Hotel ($420.00) $0.00 ($420.00) $0.00 $0.00 Total Travel ($517.00) $0.00 ($517.00) $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

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

Subcontractor (Services Procurement) Transportation & Disposal $0.00 $0.00 $0.00 $0.00 $0.00 Drilling and Well Installation ($30.00) $0.00 ($30.00) $0.00 $0.00 Mobile Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 Surveying $0.00 $0.00 $0.00 $0.00 $0.00

IDW $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

Subcontractor Subtotal ($30.00) $0.00 ($30.00) $0.00 $0.00 Handling Fee ($3.00) $0.00 ($3.00) $0.00 $0.00 Total Subcontractor Cost ($33.00) $0.00 ($33.00) $0.00 $0.00

Laboratory Sample Containers $0.00 $0.00 $0.00 $0.00 $0.00 Encore Samplers $0.00 $0.00 $0.00 $0.00 $0.00 Sample Shipping $0.00 $0.00 $0.00 $0.00 $0.00 Total Laboratory $0.00 $0.00 $0.00 $0.00 $0.00

Field Expenses Hand Auger ($24.75) $0.00 ($24.75) $0.00 $0.00 Monitoring Well Installation Kit $0.00 $0.00 $0.00 $0.00 $0.00 Groundwater Sampling Kit $0.00 $0.00 $0.00 $0.00 $0.00 Expendables ($32.50) $0.00 ($32.50) $0.00 $0.00 Personal Protection (Level D) $0.00 $0.00 $0.00 $0.00 $0.00 Teflon Tubing (1/4 inch diameter) $0.00 $0.00 Ice for Samples $0.00 $0.00 Total Survey Station $0.00 $0.00 $0.00 $0.00 $0.00 Total Field Expenses ($57.25) $0.00 ($57.25) $0.00 $0.00

Subtotal ($3,360.95) ($305.97) $0.00 ($3,054.98) $0.00 $0.00 Completion Fee ($270.42) ($30.05) $0.00 ($240.37) $0.00 $0.00

Total Estimated Cost ($3,631.37) ($336.02) $0.00 ($3,295.35) $0.00 $0.00

Date: August 27, 2018

Task #: HW560 TA CSS-18A SubTask 1 Project Management

Site: QMS Circuits SubTask 2 Work Plan & HASP

Activity/Phase: Site Inspection and Report SubTask 3 Soil Sampling,Well Installation,Groundwater Sam

Project Manager: P. Conner-FDEP/G. Wal SubTask 4 Report

SubTask 5

Totals 1 2 3 4 5 Labor Rate Category

$59.25 Project Manager (GW) 15 15.4 $55.00 Scientist V (RH) 46 2 40 4 0 $30.32 Scientist II (QK) 42 8 34 0 0 $40.62 Scientist IV (BO) 0 0 0 0 0 $24.88 Engineer I (MQ) 122 32 40 50 0 $35.25 Staff GIS Specialist (JM) 8 2 0 6 0 $23.06 Project Assistant (LC) 8 4 0 4 0

Total Hours 241 15 48 114 64 0

Direct Labor $8,218.44 $913.16 $1,311.46 $4,226.08 $1,767.74 $0.00

Overhead 143.00% $11,752.37 $1,305.82 $1,875.39 $6,043.29 $2,527.87 $0.00 Gen & Admin 12.20% $2,436.44 $270.72 $388.80 $1,252.86 $524.06 $0.00 Fringe 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Labor $22,407.25 $2,489.70 $3,575.65 $11,522.23 $4,819.67 $0.00

Other Direct Costs $410.92 $45.66 $65.57 $211.30 $88.39 $0.00 Travel

Vehicle Rental $973.00 $0.00 $973.00 $0.00 $0.00 Mileage Costs $0.00 $0.00 $0.00 $0.00 $0.00 Air Fare $381.00 $0.00 $381.00 $0.00 $0.00 Per diem + Hotel $1,512.00 $0.00 $1,512.00 $0.00 $0.00 Total Travel $2,866.00 $0.00 $2,866.00 $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

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

Subcontractor (Services Procurement) Transportation & Disposal $0.00 $0.00 $0.00 $0.00 $0.00 Drilling and Well Installation $2,475.00 $0.00 $2,475.00 $0.00 $0.00 Mobile Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 Surveying $0.00 $0.00 $0.00 $0.00 $0.00

IDW $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

Subcontractor Subtotal $2,475.00 $0.00 $2,475.00 $0.00 $0.00 Handling Fee $247.50 $0.00 $247.50 $0.00 $0.00 Total Subcontractor Cost $2,722.50 $0.00 $2,722.50 $0.00 $0.00

Laboratory Sample Containers $685.00 $0.00 $685.00 $0.00 $0.00 Encore Samplers $708.75 $0.00 $708.75 $0.00 $0.00 Sample Shipping $832.00 $0.00 $832.00 $0.00 $0.00 Total Laboratory $2,225.75 $0.00 $2,225.75 $0.00 $0.00

Field Expenses Hand Auger $173.25 $0.00 $173.25 $0.00 $0.00 Monitoring Well Installation Kit $184.30 $0.00 $184.30 $0.00 $0.00 Groundwater Sampling Kit $208.55 $0.00 $208.55 $0.00 $0.00 Expendables $97.50 $0.00 $97.50 $0.00 $0.00 Personal Protection (Level D) $84.00 $0.00 $84.00 $0.00 $0.00 Teflon Tubing (1/4 inch diameter) $175.50 $175.50 Ice for Samples $40.00 $40.00 Total Survey Station $41.75 $0.00 $41.75 $0.00 $0.00 Total Field Expenses $1,004.85 $0.00 $1,004.85 $0.00 $0.00

Subtotal $31,637.27 $2,535.36 $3,641.22 $20,552.63 $4,908.06 $0.00 Completion Fee $2,240.73 $248.97 $357.57 $1,152.22 $481.97 $0.00

Total Estimated Cost $33,878.00 $2,784.33 $3,998.79 $21,704.85 $5,390.03 $0.00

Tetra Tech, Inc.

1558 Village Square Blvd., Ste. 2, Tallahassee, FL 32309-2478

Tel 850.385.9899 Fax 850.385.9860 www.tetratech.com

October 3, 2018

Department of Environmental Protection Waste Cleanup Programs ATTN: Mr. Padraic Conner #4535 Bob Martinez Center 2600 Blair Stone Road Tallahassee, Florida 32399-2400

Reference: Florida Department of Environmental Protection (DEP) Waste Cleanup Programs Consolidated Contract HW560

Subject: Revised Change Order Request – Site Inspection at QMS Circuits, Fort Walton Beach, Florida

Dear Mr. Conner:

Tetra Tech Inc., (Tetra Tech) is providing to the Florida Department of Environmental Protection (FDEP) this request for a change order to address the accelerated schedule we achieved in conducting the field work under Subtask 3, which resulted in 1 day less in the field. The attached Task Assignment Delta and Change Order workbooks reflect changes in the following categories within Subtask 3:

1. Fewer labor hours. The accelerated schedule resulted in 8 fewer hours under this subtask for all three individuals participating in the field subtask. This reduction is based on a difference between the hours expended and the approved hours included in the task assignment.

2. Reduction in equipment, hand augers. Under the original task assignment, there were to be 7 hand auger borings, however only 6 were advanced. This resulted in usage of 3 fewer augers.

3. Decrease in vehicle. Van rental was reduced by 1 day, from 4 to 3. We had to rent the van beginning on Sunday of that week and returned the van on Wednesday morning, which resulted in 3 days rental. QK’s vehicle rental car did not change since she arrived on Sunday and returned her vehicle on Wednesday morning.

4. Hotel was reduced by 1 day for RH and MQ. QK hotel did not change.

5. Drilling cost decreased from the proposed amount by $30. This was due to fewer materials used in well installation. The invoice is attached.

Tetra Tech, Inc.

1558 Village Square Blvd., Ste. 2, Tallahassee, FL 32309-2478

Tel 850.385.9899 Fax 850.385.9860 www.tetratech.com

This reduces the total project cost by $3,631.35 (accounting for a $0.02 rounding difference between the two calculations). The revised total project cost would be $30,246.65.

If you have any questions, please call myself or Richard Hicks (850) 385-9899.

Sincerely yours, Gerald Walker, P.G.

Brownfields Program Manager rh/GAW

Attachments c: Carrie Kruchell, FDEP Richard Hicks, Tetra Tech Jay McGovern, Tetra Tech Tallahassee File FDEP Contract HW560

Conner, Padraic

From: Conner, Padraic Sent: Thursday, October 25, 2018 2:22 PM To: 'Walker, Gerry'; Hicks, Richard Cc: Cross, Justin L.; Kruchell, Carrie L.

Subject: RE: QMS Circuits TACO

That will be fine, I will adjust the dates and get it resigned and back to you.

Padraic

From: Walker, Gerry <Gerry.Walker@tetratech.com> Sent: Thursday, October 25, 2018 11:58 AM To: Conner, Padraic <Padraic.Conner@dep.state.fl.us>; Hicks, Richard <Richard.Hicks@tetratech.com> Cc: Cross, Justin L. <Justin.L.Cross@dep.state.fl.us>; Kruchell, Carrie L. <Carrie.L.Kruchell@dep.state.fl.us> Subject: RE: QMS Circuits TACO

Padaic, The due date for Task End is 11/16/18. Would you consider a time extension by 1 week to compensate for the hurricane shutdown? There are only three weeks to get draft and final to you and we are just now getting the lab data

in. What do you think? Let me know, thanks.

Gerald Walker P.G. Program Manager Direct: 850.536-8126 | Main: 850.385.9899 ext. 5368126 | Fax: 850.536-9102 gerry.walker@tetratech.com

Tetra Tech | Complex World, Clear Solutions™ Tetra Tech Inc. | Tallahassee Office 1558 Village Square Blvd., Suite 2 | Tallahassee, FL 32309 www.tetratech.com

PLEASE NOTE: This message, including any attachments, may include privileged, confidential and/or inside information. Any distribution or use of this communication by anyone other than the intended recipient is strictly prohibited and may be unlawful. If you are not the intended recipient, please notify the sender by replying to this message and then delete it from your system.

From: Conner, Padraic <Padraic.Conner@dep.state.fl.us> Sent: Thursday, October 25, 2018 9:19 AM To: Walker, Gerry <Gerry.Walker@tetratech.com>; Hicks, Richard <Richard.Hicks@tetratech.com> Cc: Cross, Justin L. <Justin.L.Cross@dep.state.fl.us>; Kruchell, Carrie L. <Carrie.L.Kruchell@dep.state.fl.us> Subject: FW: QMS Circuits TACO

Please find attached the Change Order for QMS Circuits ready for your signature.

Thanks, Padraic

From: Booeshaghi, Teresa Sent: Wednesday, October 24, 2018 2:24 PM To: Barrett, Laura K <Laura.K.Barrett@dep.state.fl.us> Cc: Cross, Justin L. <Justin.L.Cross@dep.state.fl.us>; Conner, Padraic <Padraic.Conner@dep.state.fl.us>; Cross, Justin L.

<Justin.L.Cross@dep.state.fl.us> Subject: RE: QMS Circuits TACO

From: Barrett, Laura K Sent: Wednesday, October 24, 2018 1:35 PM To: Booeshaghi, Teresa <Teresa.Booeshaghi@dep.state.fl.us> Cc: Cross, Justin L. <Justin.L.Cross@dep.state.fl.us>; Conner, Padraic <Padraic.Conner@dep.state.fl.us>; Cross, Justin L.

<Justin.L.Cross@dep.state.fl.us> Subject: FW: QMS Circuits TACO

Teresa – Attached for your review and signature is a TACO for QMS Circuits.

Laura Barrett Environmental Administrator DOD, Brownfields & CERCLA Programs Section Office: 850.245.8932

From: Conner, Padraic Sent: Wednesday, October 17, 2018 10:51 AM To: Barrett, Laura K <Laura.K.Barrett@dep.state.fl.us> Cc: Kruchell, Carrie L. <Carrie.L.Kruchell@dep.state.fl.us>; Cross, Justin L. <Justin.L.Cross@dep.state.fl.us> Subject: QMS Circuits TACO

Hello Laura, Please find attached the QMS Circuits SI Change Order along with supporting documentation.

Thank you, Padraic

Padraic Conner Environmental Specialist III Brownfields and CERCLA Administration Florida Department of Environmental Protection 2600 Blair Stone Road, MS 4535 Room 310-F Tallahassee, FL 32399

Padraic.conner@dep.state.fl.us Office: 850-245-8992 Monday – Friday: 8:30 a.m. – 5:00 p.m.

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Dep Custo

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

HW560

CERSI CER17CSS 18-A

Tetra Tech

Gerald Walker, P.G. 850-385-9889

850-245-8765Carrie Kruchell, P.G.

COM_6123

QMS Circuits

40 Hill Ave. Ft. Walton Beach, Okaloosa County

Site Inspection

The Department approves this Task Assignment (TA) in accordance with the attached Cost Proposal and Level of Effort (WP/LOE) submitted by Tetra Tech, Inc. on August 6, 2018 and revised on August 16, 2018, and August 27, 2018. This TA includes Project Management, a Site Inspection Work Plan and Health and Safety Plan, and Soil Sampling, Well installation, and Groundwater Sampling. The final deliverable is the Site Inspection Report.

Site Inspection Report

11/16/2018

12/28/2018

$ 33,878.00 $ 0.00 $ 0.00 $ 0.00

$ 0.00

$ 33,878.00

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

WCP TAFORM 04-2017

Contract Number:

Task Assignment #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

Site Inspection Workplan and HASP 09/04/2018

Field notes, monitoring well construction logs, well sampling logs, chain of custody, and photographic log from the Site Inspection Activities 09/24/2018

Final Site Inspection Report 11/16/2018

FDEP approval of the Site Inspection Work Plan and HASP (Subtask 2) $ 3,998.79

FDEP approval of the Site Inspection field notes, monitoring well construction logs, well sampling logs, chain of custody, and photographic log (Subtask 3) $ 21,704.85

FDEP approval of the Final Site Inspection Report (Subtasks 1 and 4) $ 8,174.36

$ 33,878.00

HW560

CSS-18A

QMS_Circuits_SI_change_order_revised10-3-2018.pdf
CE
QMS_Circuits_SI_chg order delta_revised10-3-18.pdf
CE
QMS_Circuits_SI_cost_estimate_original.pdf
LOE 2
QMS_Circuits_SI_cost_estimate_original.pdf
CE
QMS Circuits CSS TA18-A_8_27_18.pdf
Task Assignment Notification
BWC Task Assignment Form (Rev 02_17).pdf
Task Assignment Notification
BWC Task Assignment Form - Page 2 (Rev 08_10) - Rev 1.pdf
Deliverable & Invoice Schedule
QMS Circuits CSS TA18-A_8_27_18.pdf
Task Assignment Notification
BWC Task Assignment Form (Rev 02_17).pdf
Task Assignment Notification
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 .