CN-370000-HW682-HW16ACO2.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:

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.

HW016A 2 HW682

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

Contractor Mark A. Culbreth Contractor 813-289-9338 Multiple

PFAS Screening

$ 27,200.00 $ 27,200.00

$ 27,200.00 $ 27,200.00

Completion Completion 06/28/2024 11/29/2024 154

1 1 3

Environmental Consulting & Technology, Inc.

Contractor

Mark A. Culbreth

Contract Manager

Digitally signed by Mark Culbreth Date: 2024.06.26 13:46:35-04'00'Mark Culbreth

Mubeen Darji

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

Date: 2024.06.26 13:03:00 -04'00'

This change order authorizes a no cost time extension due to site access issues.

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

HW016A

$ 27,200.00

Email or letter report summary including one figure showing PFOA, PFOS, and PFOA+PFOS concentrations for each well sampled, field notes/forms, and the certified lab report for Fashion Square Cleaners, Jolie Cleaners, Victorian Cleaners, Email or letter report summary including one figure showing PFOA, PFOS, and PFOA+PFOS concentrations for Bolton Plaza

Email or letter report summary including one figure showing PFOA, PFOS, and PFOA+PFOS concentrations for Aldos Cleaners

Email or letter report summary including one figure showing PFOA, PFOS, and PFOA+PFOS concentrations for Miller Machinery & Supply

Email or letter report summary including one figure showing PFOA, PFOS, and PFOA+PFOS concentrations for Southside Cleaners

Upon Submittal of PFAS Deliverable, IDW Disposal Documentation and project management for Fashion Square Cleaners, Jolie Cleaners, Victorian Cleaners, and Super Cleaners

Upon Submittal of PFAS Deliverable, IDW Disposal Documentation and project management for Aldos Cleaners

Upon Submittal of PFAS Deliverable, IDW Disposal Documentation and project management for Miller Machinery & Supply

Upon Submittal of PFAS Deliverable, IDW Disposal Documentation and project management for Southside Cleaners

Upon Submittal of PFAS Deliverable, IDW Disposal Documentation and project management for Bolton Plaza

06/14/2024

07/19/2024

07/19/2024

10/25/2024

10/25/2024

$ 3,400.00

$ 13,600.00

$ 3,400.00

$ 3,400.00

$ 3,400.00

1. Contractors should:

a. Review each site and select up to 5 monitoring wells (MWs) to sample

i. MWs should be selected from source and downgradient areas that have the greatest potential to reflect PFAS impacts

ii. Offsite MWs should be avoided, and should only be selected if the site conditions or conceptual site model warrant them

iii. Proposed MWs should be:

1. Accompanied by a recent groundwater plume map and flow direction map

2. Approved by Breck Dalton

iv. Sample analysis should be through the DEP Lab (zero cost). Shipping of kits to the contractor and return shipping of samples to the lab are absorbed by the DEP Lab (a paid FedEx shipping label will be included with each kit)

v. The deliverable should be a simple email or letter report summary including one figure with text boxes (showing PFOA, PFOS, and PFOA+PFOS concentrations for each well sampled), field notes/forms, and the �certified� lab report (certified meaning that the lab report is final and not draft).

Isoconcentration/extent lines are not required on figures but can be included if the data support them.

b. Submit the deliverable within 2 working days of receipt of the certified lab report, if concentrations exceed the PGCTL of 70 ng/l in any single well from the site.

c. Copy Kelly Crain, Aaron Cohen, Jen Farrell, Doris Brown, and Breck Dalton on the email deliverable.

2. Sites included this TA:

Site Name ERIC ID

ALDOS CLEANERS 5188

BOLTON PLAZA 4269

FASHION SQUARE CLEANERS 4742

JOLIE CLEANERS & LAUNDRY 4763

MILLER MACHINERY & SUPPLY CO 4589

SOUTHSIDE CLEANERS-LAUNDERERS 5376

SUPER CLEANERS INC 4390

VICTORIAN CLEANERS 4775

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.

HW016A 01 HW682

This Task Assignment Change Order authorizes a time extension to the Task Completion Date to allow time for assessment to be completed following scheduling delays caused by site access issues.

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

Mark A. Culbreth 813-289-9338 Multiple

PFAS Screening

$ 27,200.00 $ 27,200.00

$ 27,200.00 $ 27,200.00

12/30/2023 06/28/2024 181

1 1 1

Mark A. Culbreth

Vice President

12/27/2023

Kelly Crain Digitally signed by Kelly Crain Date: 2023.12.27 09:09:19 -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