CN-370000-HW686-DC01ACO2.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.

DC001A 2 HW686

This Task Assignment Change Order authorizes an increase in cost to reconcile WCD#2, WCD #3, and WCD#4.

Skylar Schwed (850)245-8795 Contractor Contractor

Contractor Contractor

Contractor

Professional Service Industries, Inc. (Intertek-PSI) Nana G. Westmark 813-886-1075

Multiple

Multiple

✔ $ 14,199.64 $ 3,959.73

$ 14,199.64 $ 3,959.73 ✔ Completion

Completion 0

✔ 1 1 2

Professional Service Industries, Inc. (Intertek-PSI)

Nana Westmark

Senior Geologist / Principal Consultant

Nana G Westmark Digitally signed by Nana G Westmark Date: 2022.10.27 10:41:57 -04'00'

Jennifer Farrell

Digitally signed by Jennifer Farrell Date: 2022.10.27 09:47:54 -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

HW686

DC001A

$ 14,199.64

Documentation of completed site activities

Off site notice documentation and Project management.

Field notes and redesign of the SVE System at coastal cleaners & Documentation of System Shutdown before Hurricane Ian & Documentation of system restart and site conditions following Hurricane Ian and PM

Submittal and FDEP approval of Documentation of Completed Site Activities

Submittal and FDEP approval of Field notes and redesign of the SVE System at coastal cleaners, & Documentation of System Shutdown before Hurricane Ian, & Documentation of system restart and site conditions following Hurricane Ian & PM

Submittal and FDEP approval of Off site notice & Project management

12/21/2026

08/01/2022

12/01/2022

$ 1,459.73

$ 2,500.00

$ 10,239.91

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: HW686 Contract Negotiation File From: Skylar Murphy, Project Manager Date: October 24, 2022 Subject: Negotiation Summary

HW686 DC001A-2

This Task Assignment change order reconciles costs for the initiation of off-site noticing at Main Street Cleaners. Costs were authorized by work change directives WCD #2, WCD#3, and

WCD#4.

Work change directive #2 was authorized for up to $5,000 for Labor and resources to evaluate different locations for SVE lines and Wells for a potential change of system placement. The actual cost related to this was $4,380.73.

Work change directive #3 was authorized for up to $4,500 for Labor and resources to Shut down all treatment systems due to Hurricane Ian. The actual cost related to this was $2,557.95.

Work change directive #4 was authorized for up to $4,500 for Labor and resources to Re-start of all treatment systems after the shutdown caused by Hurricane Ian. The actual cost related to this was $2,240.08.

The cost increase related to this change order is $10,239.91.

The FDEP project manager agrees to the scope of work and final cost associated with this Task Assignment Change Order. The final cost for this Task Assignment Change Order is $14,199.64.

PSI may invoice following the schedule established in the Deliverables and Invoice Schedule Attachment, which accompanies the Task Assignment Change Order Notification Form.

FDEP COST ESTIMATEContractor: Professional Service Industries, Inc. (Intertek-PSI)

Date: 10/24/2022

Task #: SubTask 1 Project Management SubTask 6

Site: SubTask 2 ERIC_5272 SVE Redesign SubTask 7

Activity/Phase: Redesign of Coastal SVE system piping/loc SubTask 3 Hurricane Ian - System Shutdown SubTask 8

Project Manager: Nana Westmark SubTask 4 Hurricane Ian - System Restart SubTask 9

SubTask 5 SubTask 10

Totals 1 2 3 4 5 6 7 8 9 10 Labor Rate Category

$55.84 Project Manager 7 6.8 $0.00 Principal Consultant 0.0 0.0 0 0 0 0 0 0 0 0

$62.64 Senior Engineer, MR 5.0 5.0 0 0 0 0 0 0 0 0 $55.84 Senior Geologist, NW 6.0 0.0 3 3 0 0 0 0 0 0

$0.00 Senior Scientist 0.0 0.0 0 0 0 0 0 0 0 0 $0.00 Certified Industrial Hygientist 0.0 0.0 0 0 0 0 0 0 0 0 $0.00 Certified Hazardous Materials Manager 0.0 0.0 0 0 0 0 0 0 0 0 $0.00 Florida Licensed Asbestos Consultant 0.0 0.0 0 0 0 0 0 0 0 0 $0.00 Project Manager 0.0 0.0 0 0 0 0 0 0 0 0

$36.06 Project Engineer, MM 0.0 0.0 0 0 0 0 0 0 0 0 $38.20 Project Engineer, IK 0.0 0.0 0 0 0 0 0 0 0 0 $30.56 Project Engineer, MK 0.0 0.0 0 0 0 0 0 0 0 0 $33.99 Project Engineer, SJ 36.0 36.0 0 0 0 0 0 0 0 0 $32.44 Project Scientist, SB 0.0 0.0 0 0 0 0 0 0 0 0 $29.86 Project Scientist, EL 0.0 0.0 0 0 0 0 0 0 0 0 $29.62 Project Scientist, RF 0.0 0.0 0 0 0 0 0 0 0 0

$0.00 QA Officer 0.0 0.0 0 0 0 0 0 0 0 0 $30.59 Remediation Specialist, RH 32.0 0.0 18 14 0 0 0 0 0 0 $24.84 GIS / CAD Specialist, CF 2.0 2.0 0 0 0 0 0 0 0 0

$0.00 Staff Engineer 0.0 0.0 0 0 0 0 0 0 0 0 $0.00 Staff Geologist 0.0 0.0 0 0 0 0 0 0 0 0

$24.27 Staff Scientist, BW 0.0 0.0 0 0 0 0 0 0 0 0 $30.30 Environmental Specialist, CC 0.0 0.0 0 0 0 0 0 0 0 0 $21.21 Environmental Specialist, MZ 0.0 0.0 0 0 0 0 0 0 0 0 $20.81 Administrative Assistant, BM 0.0 0.0 0 0 0 0 0 0 0 0

$0.00 0.0 0.0 0 0 0 0 0 0 0 0 Total Hours 87.8 6.8 43.0 21 17 0 0 0 0 0 0

Direct Labor $3,277.50 $377.06 $1,586.52 $718.14 $595.78 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Overhead 151.02% $4,949.69 $569.44 $2,395.96 $1,084.54 $899.75 $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 $8,227.19 $946.50 $3,982.48 $1,802.68 $1,495.53 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

DC 001Afor WCD#2 for Coastal, Hurricane SVE Shutdown, SVE Restart

Coastal Cleaners ERIC_5272, and Hurricane Storm shutdown, restart

REV: 02/03 CEF Intertek-PSI Page 1

FDEP COST ESTIMATEContractor: Professional Service Industries, Inc. (Intertek-PSI)

Date: 10/24/2022

Task #: SubTask 1 Project Management SubTask 6

Site: SubTask 2 ERIC_5272 SVE Redesign SubTask 7

Activity/Phase: Redesign of Coastal SVE system piping/loc SubTask 3 Hurricane Ian - System Shutdown SubTask 8

Project Manager: Nana Westmark SubTask 4 Hurricane Ian - System Restart SubTask 9

SubTask 5 SubTask 10

Totals 1 2 3 4 5 6 7 8 9 10

DC 001Afor WCD#2 for Coastal, Hurricane SVE Shutdown, SVE Restart

Coastal Cleaners ERIC_5272, and Hurricane Storm shutdown, restart

Travel Vehicle Rental $240.00 $0.00 $120.00 $120.00 $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 $0.00 $120.00 $120.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor (Equipment Procurement) The Home Depot $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

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 $0.00 $40.00 $40.00 $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) $870.00 $0.00 $435.00 $435.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Field Expenses $950.00 $0.00 $475.00 $475.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subtotal $9,417.19 $946.50 $3,982.48 $2,397.68 $2,090.53 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Completion Fee $822.72 $94.65 $398.25 $180.27 $149.55 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Total Estimated Cost $10,239.91 $1,041.15 $4,380.73 $2,577.95 $2,240.08 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

REV: 02/03 CEF Intertek-PSI Page 2

LEVEL OF EFFORT/EXPENSE WORKSHEET

SITE : Coastal Cleaners ERIC_5272, and Hurricane Storm shutdown, restart SubTask 2 ERIC_5272 SVE Redesign

DATE: 10/24/2022

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Senior Engineer, M Rothenburg Technical oversight 2 Data evaluation of re-design 3

Total Hours 5 Project Engineer, S Jordan

Meet with tenant to discuss site layout, system location 3 redesign piping layout 15 electrical power evaluation 6 data evaluation 10 submittal of revised system 2

Total Hours 36

GIS, CAD Specialist, C Fugate Revise SVE system drawings Total Hours 2

TOTAL LABOR 43

VEHICLE TYPE RATE UNIT USEAGE

$0.00

Equipment Van / Truck $120.00 day 1

$0.00

TOTAL VEHICLE $0.00

PER DIEM STAFF RATE UNIT USEAGE

$0.00 $0.00 $0.00 $0.00

TOTAL PER DIE $0.00

SUBCONTRACTOR COSTS

NAME PURPOSE COST

$0.00

$0.00 $0.00

TOTAL $0.00

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC

$0.00

$0.00 $0.00

TOTAL LAB $0.00

EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS

$0.00

TOTAL EQUIPME $0.00

FINAL --7/24/96

SITE : Various Sites for Hurricane Ian SVE System Shutdown SubTask 2 Hurricane Ian - System Shutdown

DATE: 10/24/2022

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Field Activities

Remediation Specialist, R Hanson Includes travel time

Coin O Magic ERIC_4690 3 Custom Commerce ERIC_5234 3 Haines City ERIC_5357 3 Main Street ERIC_5423 3 Pugh's ERIC_4814 3 Westwood ERIC_4706 3

Total Hours: 18

Senior Geologist, N Westmark Evaluate site conditions Total Hours: 3

TOTAL LABOR 21

EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS

Construction/O&M/Pilot Test Kit $360.00 day 1 $360.00 Construction/O&M supplies $75.00 day 1 $75.00

$435.00 Expendables $40.00 day 1 $40.00

TOTAL EQUIPMENT $475.00

EQUIPMENT PROCUREM ITEM RATE COSTING UNIT USEAGE TOTALS

$0.00

VEHICLE TYPE RATE UNIT USEAGE

Equipment Van / Truck (GW Sampling) $120.00 day 1 $120.00

$420.00 week 0 $0.00

TOTAL VEHICLE $120.00

PER DIEM STAFF RATE UNIT USEAGE

$0.00

TOTAL PER DIEM $0.00

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC #IDW

TOTAL LAB $0.00

SUBCONTRACTOR COSTS

NAME PURPOSE RATE UNIT

TOTAL $0.00

TOTAL EQUIPMENT PROCUREMENT

Page 4 Copy of Reconcile Coastal Cleaners WCD 2 3 Coastal 2

SITE : Various Sites for Hurricane Ian SVE System Restart SubTask 2 Hurricane Ian - System Restart

DATE: 10/24/2022

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Field Activities

Remediation Specialist, R Hanson Includes travel time

Coin O Magic ERIC_4690 3 Custom Commerce ERIC_5234* - not restarted due to water 0 Haines City ERIC_5357 3 Main Street ERIC_5423 3 Pugh's ERIC_4814 3 Westwood ERIC_4706* - not restarted due to electrical panel trouble 2

Total Hours: 14

Senior Geologist, N Westmark Evaluate site conditions Total Hours: 3

TOTAL LABOR 17

EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS

Construction/O&M/Pilot Test Kit $360.00 day 1 $360.00 Construction/O&M supplies $75.00 day 1 $75.00

$435.00 Expendables $40.00 day 1 $40.00

TOTAL EQUIPMENT $475.00

EQUIPMENT PROCUREM ITEM RATE COSTING UNIT USEAGE TOTALS

$0.00

VEHICLE TYPE RATE UNIT USEAGE

Equipment Van / Truck (GW Sampling) $120.00 day 1 $120.00

$420.00 week 0 $0.00

TOTAL VEHICLE $120.00

PER DIEM STAFF RATE UNIT USEAGE

$0.00

TOTAL PER DIEM $0.00

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC #IDW

TOTAL LAB $0.00

SUBCONTRACTOR COSTS

NAME PURPOSE RATE UNIT

TOTAL $0.00

TOTAL EQUIPMENT PROCUREMENT

Page 5 Copy of Reconcile Coastal Cleaners WCD 2 3 Coastal 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:

Coastal Cleaners ERIC_5272

HW686 Professional Service Industries, Inc. (Intertek-PSI)

DC001A 2

Under former contract HW552 DC037E during Remediation Implementation, tenant and owner have concerns about construction of system and request change of SVE well location. and system installation.

Labor and resources to evaluate different locations of SVE lines and wells, and potential change of system placement.

$5,000.00

$ 5,000.00

Nana G Westmark Digitally signed by Nana G Westmark Date: 2022.03.18 07:59:02 -04'00'

Aaron Cohen Digitally signed by Aaron Cohen Date: 2022.03.18 15:43:56 -04'00'

Aaron Cohen Digitally signed by Aaron Cohen Date: 2022.03.18 15:44:06 -04'00'

• 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:

Various various

HW686 Professional Service Industries, (Intertek-PSI)

DC001A 3

SVE systems maintenance for Hurricane Ian, September 2022.

Shut down and re-start of all treatment systems due to Hurricane Ian.

SVE Systems located at Coin O Magic ERIC_4690, Custom Commerce ERIC_5234, Haines City ERIC_5357, Main Street ERIC_5423, Pugh's ERIC_4814, and Westwood ERIC_4702..

Estimated Labor - $3600.00 Estimated Travel, Equipment - $900.00

$ 4,500.00

Nana G Westmark Digitally signed by Nana G Westmark Date: 2022.09.26 14:29:36 -04'00'

Skylar Schwed Digitally signed by Skylar Schwed Date: 2022.09.26 15:25:11 -04'00'

Aaron Cohen Digitally signed by Aaron Cohen Date: 2022.09.26 15:36:00

• 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:

Various various

HW686 Professional Service Industries, (Intertek-PSI)

DC001A 4

SVE systems re-start for Hurricane Ian, September 30 -October 12, 2022.

Re-start of all treatment systems safter shutdown caused by Hurricane Ian.

SVE Systems located at Coin O Magic ERIC_4690, Custom Commerce ERIC_5234, Haines City ERIC_5357, Main Street ERIC_5423, Pugh's ERIC_4814, and Westwood ERIC_4702..

Estimated Labor - $3600.00 Estimated Travel, Equipment - $900.00

$ 4,500.00

Nana G Westmark Digitally signed by Nana G Westmark Date: 2022.09.30 08:31:25 -04'00'

Skylar Schwed Digitally signed by Skylar Schwed Date: 2022.09.30 08:50:14 -04'00'

Aaron Cohen Digitally signed by Aaron Cohen Date: 2022.09.30 09:00:14

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 1 HW686

This Task Assignment Change Order authorizes an increase in costs to reconcile Work Change Directive (WCD) #1 in accordance with the March 18th 2022, Scope of Work and Cost Estimate.

Skylar Murphy 850-245-8795 Contractor PSI Contractor

Contractor Nana G. Westmark Contractor 813-886-1075 Multiple

Multiple

✔ $ 1,459.73 $ 2,500.00

$ 1,459.73 $ 2,500.00 ✔ Completion

Completion 0

✔ 1 1 1

Professional Service Industries, Inc. (Intertek-PSI) Contractor Nana Westmark

Senior Geologist / Principal Consultant

Nana G Westmark Digitally signed by Nana G Westmark Date: 2022.07.29 09:23:16 -04'00'

William E. Burns, Jr.

William E. Burns, Jr. Digitally signed by William E. Burns, Jr.

Date: 2022.07.28 17:01:15 -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

HW686

DC001A

$ 3,959.73

Documentation of completed site activities

Off site notice documentation and Project management.

Submittal and FDEP approval of Documentation of Completed Site Activities

Submittal and FDEP approval of Off site notice & Project management

12/21/2026

08/01/2022

$ 1,459.73

$ 2,500.00