CN-370000-HW682-DC11ACO3.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.

DC011A 3 HW682

This Task Assignment Change Order authorizes a date extension to allow for completion of the Interim Source Removal Plan following delays caused by staffing availability.

Karlee Fowler 8502458944 Contractor Environmental Consulting and Technology, Inc. (ECT) Contractor

Contractor Mark A. Culbreth Contractor 813-289-9338

ERIC_4269

Bolton Plaza

✔ $ 16,183.76 $ 16,183.76

$ 16,183.76 $ 16,183.76 Completion

✔ Completion 12/22/2023 03/15/2024 84

✔ 1 1

Contractor Mark Culbreth

Vice President

12/20/2023

Digitally signed by Mark Culbreth Date: 2023.12.20 12:03:03-05'00'Mark Culbreth Kelly Crain Digitally signed by Kelly Crain

Date: 2023.12.20 10:05:32 -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

DC011A

$ 16,183.76

Draft Figures and Tables (Subtask 2)

ISRP and Project Management (Subtask 3 and 1)

FDEP Approval of Draft Figures and Tables (Subtask 2)

FDEP Approval of ISRP and Project Management (Subtask 3 and 1)

01/26/2024

02/16/2024

$ 3,998.37

$ 12,185.39

Printed on recycled paper.

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

From:

Date:

To: HW Contract Negotiation File

ERIC_

Project Manager

, 202 Subject: Negotiation Summary

HW

This Task Assignment Change Order

The final cost for this Task Assignment is $ with labor hours.

Fowler, Karlee

From: Leif Layton <llayton@ectinc.com> Sent: Monday, December 18, 2023 2:03 PM To: Fowler, Karlee Cc: Mark Culbreth Subject: Task Assignment DC001A-2 Bolton Plaza

EXTERNAL MESSAGE

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

Good afternoon Karlee, I would like to request a 2-month extension for Task Assignment DC011A. The reason for this request is that the additional sampling for delineation of impacted soils was delayed due to determining the sampling strategy and eld sta availability. The additional sampling was completed last week and analytical results are not expected until later this week or next week, after which the source removal report will be completed if the results show delineation was achieved.

Thank you, Leif Layton, Ph.D.

Senior Associate Engineer | Site Assessment & Remediation

Environmental Consulting & Technology, Inc.

1408 N. Westshore Blvd. | Suite 115 | Tampa, Florida, 33607 C: 813.239.7867 | D: 813.725.5855 | llayton@ectinc.com

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.

DC011A 2 HW682

This Task Assignment Change Order authorizes a date extension to allow for completion of the Interim Source Removal Plan following delays caused by needing additional sampling.

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

Contractor Mark A. Culbreth Contractor 813-289-9338

ERIC_4269

Bolton Plaza

$ 0.00 $ 0.00 Completion

✔ Completion 10/23/2023 12/22/2023 60

1 1

Contractor Mark A. Culbreth

Vice President

10/19/2023

Digitally signed by Mark Culbreth Date: 2023.10.19 17:42:37-04'00'Mark Culbreth Kelly Crain Digitally signed by Kelly Crain

Date: 2023.10.19 09:58:15 -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

HW682

DC011A

$ 16,183.76

Draft Figures and Tables (Subtask 2)

ISRP and Project Management (Subtask 3 and 1)

FDEP Approval of Draft Figures and Tables (Subtask 2)

FDEP Approval of ISRP and Project Management (Subtask 3 and 1)

07/07/2023

11/24/2023

$ 3,998.37

$ 12,185.39