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.

HW011A 3 HW680

This change order authorizes a time extension of 90 days for obtaining access.

Theresa Pepe 850-245-8966 Contractor Arcadis U.S. Inc. Contractor

Contractor Gus Suarez Contractor 813-205-4703

ERIC_4825

Southside Cleaners

$ 0.00 $ 0.00 Completion

✔ Completion 12/15/2023 03/14/2024 90

✔ 1 1 3

Arcadis U.S. Inc.

Contractor Gus Suarez

Contract Manager

Gus Suarez, P.E. Digitally signed by Gus Suarez, P.E.

Date: 2023.12.15 13:35:08 -05'00'

Kelly Crain

Kelly Crain Digitally signed by Kelly Crain Date: 2023.12.15 12:34:33 -05'00'

N/A

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

Contract Number:

Task Assignment #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

HW680

HW011A

$ 10,897.52

Annual Monitoring Report/IDW manifest

Email Summary Report -PFAS/Project Management

FDEP approval of Annual Monitoring Report/IDW manifest

FDEP approval of Email Summary Report - PFAS/Project Management

02/09/2024

02/23/2024

$ 2,229.77

$ 8,667.75

FFLORIDA DEPARTMENT OF

EEnvironmental Protection

Bob Martinez Center

2600 Blair Stone Road Tallahassee, FL 32399-2400

Ron DeSantis Governor

Jeanette NNuñez

Lt. Governor

Shawn Hamilton Secretary

Memorandum

TO: Negotiation File Southside Cleaners Facility ID No. 35-9502436; ERIC_4825 Leesburg, Lake County FROM: Theresa C. Pepe, Project Manager SUBJECT: Task Assignment Change Order HW011A-3 (HW680) DATE: December 8, 2023

The new property owner has not responded to repeated requests for access from Arcadis. The Project Manager will send another certified letter (2nd attempt) and then consult with OGC for additional options, if needed.

This change order adds 90 days to the completion date. There is no cost change to the task assignment. Arcadis may invoice according to the attached 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. 8/17/2020

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.

HW011A 2 HW680

This change order authorizes a time extension of 105 days for obtaining access.

Theresa Pepe 850-245-8966 Contractor Arcadis U.S. Inc. Contractor

Contractor Gus Suarez Contractor 813-205-4703

ERIC_4825

Southside Cleaners

✔ $ 0.00 $ 0.00

$ 0.00 $ 0.00 Completion

✔ Completion 09/01/2023 12/15/2023 105

✔ 1 1 2

Arcadis U.S. Inc.

Contractor Gus Suarez

Contract Manager

Gus Suarez, P.E. Digitally signed by Gus Suarez, P.E.

Date: 2023.08.16 13:17:31 -04'00'

Kelly Crain

Kelly Crain Digitally signed by Kelly Crain Date: 2023.08.16 10:19:36 -04'00'

N/A

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

Contract Number:

Task Assignment #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

HW680

HW011A

$ 10,897.52

Annual Monitoring Report/IDW manifest

Email Summary Report -PFAS/Project Management

FDEP approval of Annual Monitoring Report/IDW manifest

FDEP approval of Email Summary Report - PFAS/Project Management

11/06/2023

11/20/2023

$ 2,229.77

$ 8,667.75