CN-370000-HW682-DC08BCO1.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.

DC008B 01 HW682

This Task Assignment Change Order authorizes a time extension to the Task Completion Date to allow time for the NAM Report to be completed following field work scheduling delays.

Karlee Fowler 850-245-8944 Contractor Environmental Consulting and Technology, Inc. (ECT) Contractor

Contractor Mark A. Culbreth Contractor 813-289-9338

ERIC_4542

Jonfor Cleaners

✔ $ 10,887.28 $ 10,887.28

$ 10,887.28 $ 10,887.28 Completion

✔ Completion 01/29/2024 03/15/2024 46

✔ 1 1 1

Contractor Mark A. Culbreth

Principal Hydrogeologist/Contract Manager

January 29, 2024

Digitally signed by Mark Culbreth Date: 2024.01.29 14:32:31-05'00'Mark Culbreth

Jennifer Farrell

Digitally signed by Jennifer Farrell Date: 2024.01.29 14:07:29 -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

HW682

DC008B

$ 10,887.28

Email deliverable for NAM Report (Subtask 2)

IDW Manifest; Project Management (Subtasks 3 & 1)

FDEP Approval of NAM Report (Subtask 2)

FDEP Approval of IDW Manifest; Project Management (Subtasks 3 & 1)

FDEP Approval of IDW Manifest; Project Management (Subtasks 3 & 1)

02/23/2024

02/23/2024

$ 1,479.73

$ 9,407.55

FFLORIDAA DEPARTMENTT OF

EEnvironmentall Protection

Bob Martinez Center 2600 Blair Stone Road

Tallahassee, FL 32399-2400

Ronn DeSantis Governor

Jeanette Nuñez Lt. Governor

Shawnn Hamilton Secretary

Memorandum

TO:

FROM:

SUBJECT:

DATE:

HW682 Contract File Jonfor Cleaners

ERIC_4542

Project Manager Negotiation Summary Task Assignment DC008

This Task Assignment final cost $ ECT may invoice according to the attached schedule.

Fowler, Karlee

From: Mark Culbreth <mculbreth@ectinc.com> Sent: Friday, January 26, 2024 11:31 AM To: Fowler, Karlee Subject: RE: Jonfor Cleaners DC008B

EXTERNAL MESSAGE

This email originated outside of DEP. Please use caution when opening attachments, clicking links, or responding to this email.

Karlee.

Greg tells me we should request an extension. I would think two or three weeks should be sufficient.

Thank you

Mark A. Culbreth, P.G. (Florida) Vice President | Site Assessment & Remediation

Environmental Consulting & Technology, Inc.

1408 North Westshore Blvd. Suite 115 | Tampa, Florida 33607 813-725-5950 (Direct) | 813-382-8953 (Mobile) mculbreth@ectinc.com | www.ectinc.com

From: Fowler, Karlee <Karlee.Fowler@FloridaDEP.gov> Sent: Friday, January 26, 2024 11:24 AM To: Mark Culbreth <mculbreth@ectinc.com> Subject: Jonfor Cleaners DC008B

Hi Mark, I just wanted to check with you on Jonfor Cleaners. The task end date is this coming Monday, January 29th. If a time extension is needed, please let me know ASAP so I can get one put together for signature by Monday.

Thanks!

Karlee Fowler, P.G.

Professional Geologist I Waste Site Cleanup Section (WSCS) Karlee.Fowler@FloridaDEP.gov Office: 850-245-8944

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.

HW682

DC008B Completion January 29, 2024

This Task Assignment authorizes ECT to to conduct annual groundwater sampling activities at the Jonfor Cleaners site located in Jacksonville, Florida. All work will be conducted in accordance with the scope of work and cost proposal submitted on June 7, 2023.

Ginger Shirah 850-245-8899 Contractor Environmental Consulting and Technology, Inc. (ECT) Contractor

Contractor Mark A. Culbreth Contractor 813-289-9338

ERIC_4542

11700-1 San Jose Blvd., Jacksonville, Duval County, FL

Jonfor Cleaners

Contractor Contractor

✔ $ 10,887.28

$ 10,887.28

Select One

Environmental Consulting and Technology, Inc. (ECT Contractor Mark A. Culbreth

Contract Manager

6/20/2023

Digitally signed by Mark Culbreth Date: 2023.06.20 15:37:21-04'00'Mark Culbreth Kelly Crain Digitally signed by Kelly Crain

Date: 2023.06.20 15:29:16 -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

Annual NAM Report (Subtask 2) 10/28/2023

IDW Manifest; Project Management (Subtasks 1 & 3) 12/28/2023

Approval of Annual NAM Report (Subtask 2) $ 9,407.55

Approval of IDW Manifest; Project Management (Subtasks 1 & 3) $ 1,479.73

$ 10,887.28

HW682

DC008B