CN-370000-HW680-DC014F.pdf

Funding Information:

Org. Code E.O. Object Code Budget Entity Appropriation

Category Grant # Project # Year Amount

☐ Additional Funding Information attached on separate page.

Rev. 8/17/2020

STATE OF FLORIDA

DEPARTMENT OF ENVIRONMENTAL PROTECTION

Task Assignment Change Order This Change Order is entered into between the Parties named below and amends the Task Assignment (TA) and any previous TA Change Orders (TACO) as follows:

1. TA Number: TACO Number: Contract Number:

TACO Description:

2. Parties State of Florida Department of Environmental Protection (Department) Department’s Project Manager: Department’s Project Manager Phone:

Contractor Name: (Contractor ) ntractor’st ’s Project Manager: ontractor’s t’s Project Manager Phone:

3. Project Number:

(If different from TA Number) Project Name:

4. ☐ There are no changes to the TA compensation.

☐ The compensation of the TA is changed to the amounts indicated below:

Amended Price Price Prior to TACO ☐ Fixed Price:

☐ Fixed Unit Rate: (Extended Price)

☐ Cost Reimbursement:

Total TA Value:

5. ☐ There are no changes to the TA Expiration Date.

☐ The TA Completion Date is changed from ______________ to ______________ (a total of ______ days).

6. ☐ There are no changes to the Attachments.

☐ Attachment ___ is replaced with Attachment -____.

7. ☐ No Additional Changes.

☐ Additional Changes:

8. All other terms and conditions of the TA remain in effect. If and to the extent that any inconsistencies may appear between the TA and this TACO, the provisions of this TACO shall control.

IN WITNESS WHEREOF, this TACO shall be effective on the last date signed below.

State of Florida Department of Environmental Protection

CONTRACTOR Department Name:

Title: Secretary or Designee

(Authorized Signature) (Authorized Signature) Date:

☐ Additional signatures attached on separate page.

DC010C 1

HW685

Patrick McGrane 850-245-8899 Contractor Contractor

Contractor Contractor

Contractor

WSP USA Inc.

WSP USA Inc.

Matt Crews 904-363-3430

ERIC_4553

Swift Cleaners Inc. (Cesery)

✔ $ 25,605.79 $ 25,605.79

$ 25,605.79 $ 25,605.79 Completion

Completion✔ 11/29/2024 03/28/2025 119

✔ 1 1

Matthew Crews

Environmental Engineer

10/23/2024

Crews, Matt (USMC700671) Digitally signed by Crews, Matt (USMC700671) Date: 2024.10.23 09:59:32 -04'00'

Mubeen Darji

Mubeen Darji, P.E. Digitally signed by Mubeen Darji, P.E.

Date: 2024.10.23 08:42:28 -04'00'

N/A

This Change Order authorizes a no cost time extension to the Task Assignment Completion date and all deliverable due dates.

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

Contract Number:

Task Assignment #:

Change Order #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

BWC TAFORM 01/18

DC010C

HW685

Subtask 3 - PFAS Related Costs and IDW Management

Subtask 1 & 4 - Project Management; 2024 Annual Groundwater Monitoring Report

Subtask 2 - Annual Groundwater Monitoring 11/22/2024

12/06/2024

01/10/2025

Subtask 2 - Submittal and FDEP approval of field documentation and certified laboratory analytical report for chlorinated VOCs

Subtask 3 - Submittal and FDEP approval of field documentation, certified laboratory analytical report for PFAS, signed waste manifest

Subtask 1 & 4 - Project Management; Submittal and FDEP approval of the 2024 Annual Groundwater Monitoring Report

$ 11,020.22

$ 6,500.42

$ 8,085.15

$ 25,605.79

FLORIDA DEPARTMENT OF

Environmental Protection

Bob Martinez Center

2600 Blair Stone Road Tallahassee, FL 32399-2400

Ron DeSantis Governor

Jeanette Nuñez

Lt. Governor

Shawn Hamilton Secretary

Memorandum

TO: Negotiation File

Swift Cleaners Inc.

Jacksonville, Duval County

ERIC_4553

FROM: Patrick McGrane, Project Manager

SUBJECT: Negotiation Summary Task Assignment Change Order DC010C-1 (HW685)

DATE: October 22, 2024

This Change Order authorizes a no cost time extension to the task assignment completion date and Subtask 2, 3, & 4 deliverable due dates due to issues with scheduling and WSP staffing.

The final cost total remains $25,605.79. The task assignment completion date was extended from 11/29/2024 to 3/28/2025.

WSP may invoice according to the included schedule.

Funding Information:

Org. Code E.O. Object Code Budget Entity Appropriation

Category Grant # Project # Year Amount

Additional Funding Information attached on separate page.

Rev. 8/26/2020

STATE OF FLORIDA

DEPARTMENT OF ENVIRONMENTAL PROTECTION

Task Assignment This Task Assignment (TA) is entered into between the Parties named below, pursuant to Contract Number: .

1. TA Number: TA Completion Date:

TA Description:

2. Parties State of Florida Department of Environmental Protection (Department)

Department Project Manager: Department Project Manager Phone:

Contractor Name: (Contractor ) ntractor’st ’s Project Manager: ontractor’s t’s Project Manager Phone:

3. Project Number:

(If different from TA Number)

Project Location(s):

Project Name:

4. As consideration for the services rendered by Contractor under the terms of this TA, the Department shall pay the Contractor on the following bases, up to the Total TA Value as indicated below:

Fixed Price:

Fixed Unit Rate: (Extended Price)

Cost Reimbursement:

Total TA Value:

5. The Parties agree to comply with the terms and conditions of the underlying the Contract, and the following attachments which are hereby incorporated by reference:

Attachment 1:

Additional Attachments (if necessary):

IN WITNESS WHEREOF, this TA shall be effective on the last date signed below.

State of Florida Department of Environmental Protection

CONTRACTOR Department Name:

Title: Secretary or Designee

(Authorized Signature) (Authorized Signature) Date:

Additional signatures attached on separate page.

HW685

DC010C Completion November 29, 2024

This Task Assignment authorizes WSP to conduct Annual Groundwater Monitoring at Swift Cleaners Inc. (Cesery) in accordance with the April 4, 2024 Scope of Work, Cost Estimate, and Bid Documentation.

Patrick McGrane 850-245-8899 Contractor WSP USA Inc. Contractor

Contractor Matt Crews Contractor 904-363-3430

ERIC_4553

2754 Cesery Boulevard, Jacksonville, Duval County

Swift Cleaners Inc. (Cesery)

Contractor Contractor

✔ $ 25,605.79

$ 25,605.79

Scope of Work

WSP USA Inc.

Contractor Matthew Crews

Environmental Engineer

4/15/2024

Crews, Matt (USMC700671) Digitally signed by Crews, Matt (USMC700671) Date: 2024.04.15 09:38:51 -04'00'

Mubeen Darji

Mubeen Darji, P.E. Digitally signed by Mubeen Darji, P.E.

Date: 2024.04.11 10:35:03 -04'00'

N/A

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

WC TAFORM

Contract Number:

Task Assignment #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

Subtask 2 - Annual Groundwater Monitoring 06/14/2024

Subtask 3 - PFAS Related Costs and IDW Management 07/12/2024

Subtask 1 & 4 - Project Management; 2024 Annual Groundwater Monitoring Report 08/09/2024

Subtask 2 - Submittal and FDEP approval of field documentation and certified laboratory analytical report for chlorinated VOCs $ 11,020.22

Subtask 3 - Submittal and FDEP approval of field documentation, certified laboratory analytical report for PFAS, signed waste manifest $ 6,500.42

Subtask 1 & 4 - Project Management; Submittal and FDEP approval of the 2024 Annual Groundwater Monitoring Report $ 8,085.15

$ 25,605.79

HW685

DC010C