CN-370000-HW683-DC01ACO2.pdf
PDF 3 MB Posted
- Contract number
- HW683
- Issued by
- Florida
About this file
This document set comprises a Task Assignment (TA) and related Task Assignment Change Orders (TACOs) between the State of Florida Department of Environmental Protection (FDEP) and Geosyntec Consultants for environmental response and assessment services under Contract Number HW683. The contract authorizes Geosyntec to address critical issues at Waste Site Cleanup Section sites on an as-needed basis, with work performed across multiple project locations in Florida, including sites in Tampa Bay and Paines Prairie State Park. The contract is managed by FDEP Project Manager Brittany Plyler (later Evan Miller) and Geosyntec Contract Manager Todd K. Kafka.
The initial Task Assignment (DC001A) established a fixed unit rate compensation structure with a total value of $2,500.00 for documentation of completed site activities. Two subsequent TACOs increased the compensation: TACO 1 (dated March 1, 2022) increased the total TA value to $12,677.66 to reconcile Work Change Directive 1 for soil sample analysis, and TACO 2 (dated October 26, 2023) increased the value to $16,530.02 to reconcile Work Change Directive 2 for multiple site visits following Hurricane Idalia in August 2023. The work involved 27 labor hours and included soil analytical data, sampling summaries, project management, and post-hurricane photo documentation of six Tampa Bay sites and Paines Prairie State Park. Deliverables were scheduled through December 22, 2026, with invoicing contingent upon FDEP receipt and approval of analytical data and photographic documentation.
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Text version
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.
DC001A 2 HW683
This Task Assignment Change Order reconciles WCD 2 for multiple site visits to determine if any impacts had occurred following the passage of Hurricane Idalia in late August 2023.
Brittany Plyler 850-245-8851 Contractor Contractor
Contractor Contractor
Contractor
Geosyntec Todd Kafka 813-379-4396
Multiple
Critical Response
✔ $ 16,530.02 $ 12,677.66
$ 16,530.02 $ 12,677.66 ✔ Completion
Completion 0
✔ 1 1 2
Geosytec
Todd Kafka
Contract Manager
Todd Kafka, P.G. Digitally signed by Todd Kafka, P.G.
Date: 2023.10.26 16:54:56 -04'00'
Kelly Crain
Kelly Crain Digitally signed by Kelly Crain Date: 2023.10.26 16:43:50 -04'00'
N/A
Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment
WCP TAFORM 01_18
Contract Number:
Task Assignment #:
Change Order #:
Deliverables:
Deliverable Deliverable Due Date
Invoice Schedule:
Requirements for Invoice Submittal Amount to be Invoiced
TOTAL COST
HW683
DC001A
$ 16,530.02
Documentation of completed site activities
Subtask 1,2- Soil Analytical Data and Soil Sampling Summary; Project Management
Subtask 3: Post Hurricane Idalia Photo Documentation
Documentation of completed site activities
Subtask 3: Post Hurricane Idalia Photo Documentation
Subtask 1,2- Soil Analytical Data and Soil Sampling Summary; Project Management
12/22/2026
03/22/2022
09/01/2023
$ 10,177.66
$ 2,500.00
$ 3,852.36
Printed on recycled paper.
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
To: HW683 Contract Negotiation File Critical Response Multiple ERIC_Mutiple
From: Brittany Plyler, Project Manager Date: October 26, 2023 Subject: Negotiation Summary
HW683_DC01A-2
This Task Assignment Change Order reconciles WCD 2 for multiple site visits to determine if any impacts had occurred following the passage of Hurricane Idalia in late August 2023.The total increase is $3,852.36, with 27 labor hours.
Geosyntec confirmed on October 26, 2023, that Subtask 1 consists of the calculated project management labor, based upon 13% of the direct labor costs in this proposal, and includes fringe, overhead, other direct costs (ODCs) and completion fees.
Subtask 3: WCD 2 was used for Geosyntec to visit 6 sites in Tampa Bay, and a site in Micanopy following Hurricane Idalia. The site visits included an inspection of the property, any IDW containers, remediation systems, or monitoring equipment.
The FDEP Project Manager agrees to the scope of work and final cost associated with this TACO. The final cost is for this TACO is $16,530.02.
FDEP COST ESTIMATEContractor: Geosyntec Consultants
Date: 10/16/2023
Task #: DC001A SubTask 1 Project Management SubTask 6
Site: multiple SubTask 2 Hurricane Idalia storm visits SubTask 7
Activity/Phase: SubTask 3 SubTask 8
Project Manager: Cain SubTask 4 SubTask 9
SubTask 5 SubTask 10
Totals 1 2 3 4 5 6 7 8 9 10 Labor Rate Category
$49.04 Project Manager O.Cain 3 2.8 $86.54 Principal T. Kafka 3 3 0 0 0 0 0 0 0 0 $49.76 Senior Professional B. Dawson 2 2 0 0 0 0 0 0 0 0 $49.04 Project Professional O. Cain 1 1 0 0 0 0 0 0 0 0 $45.19 Professional F. Fortes 1 1 0 0 0 0 0 0 0 0 $37.02 Senior Staff Professiona K. Pierce 8 8 0 0 0 0 0 0 0 0 $33.41 Staff Professional D. McGill 7 7 0 0 0 0 0 0 0 0 $29.35 Administrative Assistant T. Hampton 2 2 0 0 0 0 0 0 0 0
Total Hours 27 3 24 0 0 0 0 0 0 0 0
Direct Labor $1,177.57 $135.47 $1,042.10 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Overhead 172.70% $2,033.67 $233.96 $1,799.71 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Gen & Admin 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fringe 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Labor $3,211.24 $369.43 $2,841.81 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Travel Vehicle Rental $240.00 $240.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Mileage Costs $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Air Fare $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Per diem + Hotel $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Travel $240.00 $240.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Subcontractor (Equipment Procurement) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Subcontractor Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Procurement Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
TACO-1 Page 1 of 3 TACO-1
FDEP COST ESTIMATEContractor: Geosyntec Consultants
Date: 10/16/2023
Task #: DC001A SubTask 1 Project Management SubTask 6
Site: multiple SubTask 2 Hurricane Idalia storm visits SubTask 7
Activity/Phase: SubTask 3 SubTask 8
Project Manager: Cain SubTask 4 SubTask 9
SubTask 5 SubTask 10
Totals 1 2 3 4 5 6 7 8 9 10 Subcontractor (Services Procurement)
Drilling (Conventional) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Drilling (Non-conventional) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Mobile Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Surveying $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
IDW $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Utilities $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Subcontractor Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Handling Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Laboratory Analytical Costs $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fast Turnaround Charges $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Sample Shipping $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Field Expenses Personal Protection $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Expendables $80.00 $80.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Drilling related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Analytical related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (IDW related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Other) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Field Expenses $80.00 $80.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Subtotal $3,531.24 $369.43 $3,161.81 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Completion Fee $321.12 $36.94 $284.18 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Total Estimated Cost $3,852.36 $406.37 $3,445.99 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
TACO-1 Page 2 of 3 TACO-1
LEVEL OF EFFORT/EXPENSE WORKSHEET
SITE : multiple SUBTASK: Hurricane Idalia storm visits
DATE: ########
LABOR CATEGORY
STAFF-TITLE HOURS
Principal T. Kafka 3
Senior B. Dawson 2
Project Prof O. Cain 1
Professional 1 F. Fortes
Senior Staff Professional K. Pierce 8
Staff Professional D. McGill 7
Drafter/CADD Operator
Administrative Assistant T. Hampton 2
TOTAL LABOR 24
VEHICLE TYPE RATE UNIT USEAGE
Car $80.00 Day $0.00 Truck $120.00 Day 2 $240.00 Van $120.00 Day 0 $0.00
Subtotal $240.00
Mileage $0.59 Mile 0 $0.00 Subtotal $0.00
Air Fare $0.00 Round Trip 0 $0.00 Subtotal $0.00
TOTAL VEHICLE $240.00
PER DIEM STAFF RATE UNIT USEAGE
TOTAL PER DIEM $0.00
SUBCONTRACTOR COSTS
TOTAL SUB $0.00
LABORATORY COSTS
TOTAL LAB $0.00
EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS
Expendables
$40.00 Day 2 $80.00 Subtotal $80.00
TOTAL EQUIPMENT $80.00
*PROVIDE TIME REQUIRED FOR EACH PERSON
WORK DESCRIPTION
review/submit final deliverables for all site visits field notification and review photo logs for PPSP field notification for 3 of TB sites field notification for 3 of TB sites
Visit 6 TB sites and photo log
PPPSP site visit and photo log compile pdfs for sites
10/23/2023 Page 3 of 3 CO ST 2
Site Name: Site ID #:
Contract #: Contractor:
• Reason for Work Change Directive :
• Description of Work Change Directive :
• Attachments (if applicable, list documents supporting change):
• Costs (if negotiated unit costs, provide information below):
WCP WCD 07-2018
Authorized Contractor Signature:
Authorized FDEP Signature:
WORK CHANGE DIRECTIVE FORM
FDEP Supervisor Approval:
(if applicable)
Additional work is not authorized without prior FDEP approval as indicated by an approved Work Change Directive Form or Task Assignment Change Order Form. It is the Contractor's responsibility to ensure that additional costs associated with this WCD are resolved by a Task Assignment Change Order (TACO) prior to the completion date of the original Task Assignment or subsequent TACOs completed prior to the execution date of this WCD. Failure to do so will result in a loss of reimbursement for work associated with this WCD.
Task Assignment #: Work Change Directive #:
Maximum Estimated Increase in Task Amount:
Critical Reponse
HW683 Geosyntec
DC001A
visit 6 Tampa Bay sites and Paines Prairie SP to document if flooding has affected sites labor to visit sites and prepare photo logs for FDEP
$ 4,000.00
Todd Kafka, P.G.
Digitally signed by Todd Kafka, P.G.
Date: 2023.09.01 12:24:37 -04'00'
Kelly Crain Digitally signed by Kelly Crain Date: 2023.09.01 13:04:02 -04'00'
Kelly Crain Digitally signed by Kelly Crain Date: 2023.09.01 13:04:10 -04'00'
12802 Tampa Oaks Boulevard, Suite 151 Tampa, Florida 33637
PH 813.558.0990
www.geosyntec.com
25 October 2023
Ms. Brittany Plyler Florida Department of Environmental Protection 2600 Blair Stone Road Tallahassee, FL 32399-2400
Subject: Scope of Work/Level of Effort Hurricane Idalia Site Visits
DC001A – TACO #1
Dear Ms. Plyler, As requested by FDEP, Geosyntec conducted multiple site visits to determine if any impacts had occurred following the passage of Hurricane Idalia in late August 2023. Geosyntec received an approved Work Change Directive from FDEP on September 1, 2023 in the amount of $4,000 to conduct these tasks
A summary of the scope of work and costs associated with TACO #1 is provided below in red text.
Subtask 1 – Project Management
Subtask 2 – Post Storm Visits
Geosyntec personnel visited 6 sites in Tampa Bay following the passage of Idalia: Musselman Steel (ERIC_3898), Gentle Touch Cleaners (ERIC_4712), Former Peacock Dry Cleaners (ERIC_5330), Former Scott’s Northwoods Cleaners (ERIC_5307), Former Pelican Dry Cleaners (ERIC_5292), and Former Trophy Cleaners (ERIC_5301). The site visits included an inspection of the property, any IDW containers, remediation systems, or monitoring equipment. Geosyntec personnel also visited Paines Prairie State Park (Micanopy, FL) to inspect and photodocument site conditions related to backfill material and runoff of a recent soil excavation. Our labor included field notifications to owners and tenants, mobilization, on-site inspection, photodocumentation, and preparing a photolog for FDEP as a deliverable submitted on 9/5/23.
Ms. Brittany Plyler 25 October 2023
Deliverable and Invoicing Schedule:
The WCD #1 total is $3,852.36, below the approved total of $4,000. The TACO #1 increase is $3,852.36.
Subtask Deliverable Deliverable Due Date Invoice Amount
1, 2 Hurricane Idalia Photo log 9/5/23 $3,852.36
Period of Performance 29 December 2023
Total: $3,852.36
As always, it is a pleasure to work with the FDEP. If you require any additional information or have any questions, please contact me at 813.379.4396.
Sincerely, Todd K. Kafka, P.G.
Sr. Principal Hydrogeologist
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.
DC001A 1 HW683
This task assignment change order reconciles work change directive 1 for soil sample analysis.
Evan Miller 850-245-8928 Contractor Geosyntec Contractor
Contractor Todd Kafka Contractor 813-379-4396 Multiple
Multiple
✔ $ 10,177.66 $ 2,500.00
$ 10,177.66 $ 2,500.00 ✔ Completion
Completion 0
✔ 1 1 1
Contractor Todd Kafka
Contract Manager
3-1-22
Todd Kafka, P.G. Digitally signed by Todd Kafka, P.G.
Date: 2022.03.01 15:00:18 -05'00'
William E. Burns, Jr.
William E. Burns, Jr. Digitally signed by William E. Burns, Jr.
Date: 2022.03.01 14:42:44 -05'00'
Contract Number:
Task Assignment #:
Deliverables:
Deliverable Deliverable Due Date
Invoice Schedule:
Requirements for Invoice Submittal Amount to be Invoiced
TOTAL COST
HW683
DC001A
$ 12,677.66
Subtask 1,2- Soil Analytical Data and Soil Sampling Summary/Project Management
Documentation of completed site activities
Subtask 1,2- FDEP receipt and approval of Soil Analytical Data and Soil Sampling Summary/Project Management
Receipt and approval of documentation of completed site activities
03/31/2022
12/22/2026
$ 2,500.00
$ 10,177.66
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.
HW683
DC001A December 22, 2026
This Task Assignment authorizes Geosyntec Consultants (GEO) to address critical issues at Waste Site Cleanup Section sites on an as needed basis in accordance with a request from the Waste Site Cleanup Section.
Evan Miller 850-245-8928 Geosyntec Consultants
Todd K. Kafka 813-379-4396
Multiple
Multiple
Multiple
$ 0.00
$ 2,500.00
$ 0.00
$ 2,500.00
Scope of Work
Geosyntec Consultants
Todd K. Kafka
Contract Manager
Todd Kafka, P.G. Digitally signed by Todd Kafka, P.G.
Date: 2022.01.04 08:47:04 -05'00'
William E. Burns Jr.
William E. Burns, Jr. Digitally signed by William E. Burns, Jr.
Date: 2022.01.03 12:04:46 -05'00'
WC TAFORM
Contract Number:
Task Assignment #:
Deliverables:
Deliverable Deliverable Due Date
Invoice Schedule:
Requirements for Invoice Submittal Amount to be Invoiced
TOTAL COST
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