CN-370000-HW561-DC08PCO2.pdf
PDF 125 KB Posted
- Contract number
- HW561
- Issued by
- Florida
About this file
This document is a Task Assignment Notification Change Order Form (Change Order No. 2) issued by the Florida Department of Environmental Protection (DEP) for Contract No. HW561. The contractor is Golder Associates, represented by Matt Crews, with Ben Grubbs serving as the DEP Contract Manager. The work location is Jays Professional Dry Cleaners & Laundry (Site ID ERIC_4521).
The change order authorizes a 45-day time extension for groundwater monitoring activities that were delayed by excavation activities at the site. The task maintains a fixed price of $7,495.59 with no increase in costs. The original task completion date of November 1, 2021, has been extended to December 16, 2021. Deliverables include a Groundwater Monitoring Report and ADaPT/GIS update due November 15, 2021, comprised of two subtasks: groundwater monitoring field and IDW treatment documentation with lab reports ($3,977.58) and annual groundwater monitoring report with ADaPT/GIS updates and project management ($3,518.01). Invoice payments are contingent upon FDEP approval of both deliverable components.
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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
HW561
2DC008P
Golder Associates Matt Crews
(850) 245-8992Ben Grubbs Jays Professional Dry Cleaners & Laundry
ERIC_4521
This Task Assignment Change Order authorizes a time extension due to groundwater monitoring being delayed by excavation activities.
Annual Groundwater Monitoring Report and ADaPT/GIS update 11/15/2021
$ 7,592.59 $ 0.00 $ 0.00 $ 0.00
$ 7,495.59 $ 0.00 $ 0.00 $ 0.00 $ 7,495.59
$ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00
$ 7,495.59
11/01/2021
11/01/2021
45 days
12/16/2021
Benjamin Grubbs Digitally signed by Benjamin Grubbs Date: 2021.10.28 08:17:01 -04'00'
Benjamin Grubbs Digitally signed by Benjamin Grubbs Date: 2021.10.28 08:17:12 -04'00'
William E. Burns, Jr. Digitally signed by William E. Burns, Jr.
Date: 2021.10.28 20:24:58 -04'00'
Jesse Brown Digitally signed by Jesse Brown Date: 2021.11.01 08:41:15 -04'00'
$ 7,495.59 $ 0.00 $ 0.00 $ 0.00
$ 7,592.59
Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment
BWC TAFORM 2/03
Contract Number:
Task Assignment #:
Deliverables:
Deliverable Deliverable Due Date
Invoice Schedule:
Requirements for Invoice Submittal Amount to be Invoiced
TOTAL COST
HW561
DC008P
$ 7,495.59
Subtask 2: Groundwater monitoring field and IDW treatment documentation and lab report
Subtasks 1 & 4: Annual Groundwater Monitoring Report and ADaPT/GIS update/Project Management
Subtask 2: Submittal and FDEP approval of groundwater monitoring field and IDW treatment documentation and lab report
Subtasks 1 & 4: Submittal and FDEP approval of Annual Groundwater Monitoring Report and ADaPT/GIS update/Project Management
08/02/2021
11/15/2021
$ 3,518.01
$ 3,977.58
File details come from the government source that posted it. Updated .