CN-370000-HW684-BIL2DCO1.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.

BIL02D 1 HW684

The Department approves this Task Assignment Change Order (TACO) for changes to the TA Completion date.

Allison Hankins 850 245 8990 GHD Services, Inc.

Brian Moore 813 971 3882

ERIC_13343

Former Polk County Fertilizer

$ 41,735.09 $ 41,735.09

$ 41,735.09 $ 41,735.09

09/30/2024 11/15/2024 46

1 1 1

GHD Services, Inc.

Brian Moore

Vice President

Brian Moore Digitally signed by Brian Moore Date: 2024.07.11 16:52:14 -04'00'

Jennifer Farrell

Digitally signed by Jennifer Farrell Date: 2024.07.10 14:15:17 -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

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

Memorandum

TO: GHD Services Inc. HW684 Contract File

FROM: Allison Hankins, Contract Manager

DATE: July 10, 2024

SUBJECT: Negotiation Summary – BIL22, Change Order #1 - TA BIL02D Former Polk County Fertilizer - Site ID # ERIC_13343 Targeted Brownfield Site Assessment Activities

This Task Assignment Change Order (TACO) is for a change in due date, from September 30, 2024 to November 15, 2024. Specific changes are detailed below:

Subtask 1: Project Management There are no changes in cost associated with this Subtask.

Subtask 2: Soil Assessment There are no changes in cost associated with this Subtask.

Subtask 3: Site Assessment Report Addendum There are no changes in cost associated with this Subtask.

Summary The Department’s SRP Contract Manager and GHD’s Contract Manager have both agreed to the scope of work and associated costs. The final cost associated with this TA is $41,735.09.

Documentation of these costs is included in the Cost Proposal/Level of Effort (CP/LOE) Form and CP/LOE narrative provided by GHD on June 20, 2024, and the TA Form for BIL02D prepared by the Department. The final deliverable for this TA must be received by the Department no later than October 17, 2024.

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.

HW684

BIL02D Completion September 30, 2024

GHD Services, Inc. will conduct soil assessment activities and prepare a Site Assessment

Report Addendum in accordance with the cost proposal and Level of Effort (LOE) submitted on June 20, 2024.

Allison Hankins 850 245 8990 Contractor GHD Services, Inc. Contractor

Contractor Brian Moore Contractor 813 971 3882

ERIC_13341

0 Citrus Ave, Haines City

Former Polk County Fertilizer

Contractor Contractor

$ 41,735.09

$ 41,735.09

Scope of Work

GHD Services, Inc.

Contractor

Brian Moore

Vice President

Brian Moore Digitally signed by Brian Moore Date: 2024.07.07 21:16:32 -04'00'

Jennifer Farrell

Digitally signed by Jennifer Farrell Date: 2024.07.01 08:41:56 -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

Soil Data and Field Notes 09/18/2024

Site Assessment Report Addendum 10/17/2024

DEP approval of Soil Data and Field Notes $ 30,814.39

DEP approval of Site Assessment Report Addendum $ 10,920.70

$ 41,735.09

HW684

BIL02D