CN-370000-HW686-DC10ACO1.pdf
PDF 2 MB Posted
- Contract number
- HW686
- Issued by
- Florida
About this file
This document package comprises a Task Assignment (TA) and Task Assignment Change Order (TACO) between the State of Florida Department of Environmental Protection (FDEP) and Professional Service Industries, Inc. (Intertek-PSI) under Contract Number HW686. The assignment involves construction observation and remedial services at the Haines City Quality Cleaners facility (ERIC_5357) located at 511 Haines City Mall in Haines City, Polk County, Florida. The contract is managed by FDEP Project Manager Skylar Murphy and Intertek-PSI Project Manager Nana G. Westmark.
The original Task Assignment (DC010A) authorized PSI to conduct construction observations at the site with an initial total value of $3,437.20, comprised of two invoice milestones: $1,575.84 for construction plan review and site visit documentation (due 05/30/2022) and $1,861.36 for construction observation documentation and project management (due 07/20/2022). TACO #1, executed on July 29 and August 1, 2022, increased the task value to $8,913.16, adding $5,475.99 to cover additional construction materials, equipment, and labor costs associated with redesign and re-piping of an SVE (Soil Vapor Extraction) line necessitated by neighboring site redevelopment. The change order encompasses 85 hours of labor distributed across four subtasks: project management ($859.54), construction plan review/site visit ($1,575.84), construction observations ($1,511.37), and SVE re-piping ($4,966.43). Cost increases were authorized to protect system integrity and maintain relationships with the responsible party organization, with invoicing contingent upon FDEP approval of all deliverables.
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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.
DC010A 1 HW686
Additional construction materials, equipment and labor costs from the originally estimated $3,437.20 to $8,913.19 in accordance with PSI’s TACO request received on July 6, 2022.
Skylar Murphy 850-245-8795 Contractor Contractor
Contractor Contractor
Contractor
PSI
Nana G. Westmark 813-886-1075
ERIC_5357
Haines City Quality Cleaners
✔ $ 8,913.16 $ 3,437.20
$ 8,913.16 $ 3,437.20 ✔ Completion
Completion 0
✔ 1 1 1
Professional Service Industries, Inc. (Intertek-PSI)
Nana Westmark
Senior Geologist / Principal Consultant
Nana G Westmark Digitally signed by Nana G Westmark Date: 2022.08.01 11:18:34 -04'00'
William E. Burns, Jr.
William E. Burns, Jr. Digitally signed by William E. Burns, Jr.
Date: 2022.07.29 12:21:54 -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
DC010A
$ 8,913.16
Subtask 2: Construction plan review/ site visit documentation.
Subtasks 1 & 3: Construction Observation doumentation. Project management.
Subtask 4: Letter report deliverable documenting the re-piping for the Haines City site
Subtask 2: Submittal and FDEP approval of the Construction plan review/ site visit documentation
Subtask 4: Submittal and FDEP approval of the letter report deliverable documenting the re-piping for the Haines City site
Subtasks 1 & 3: Submittal and FDEP approval of the Construction Observation documentation. Project management.
05/30/2022
07/20/2022
07/20/2022
$ 2,370.89
$ 1,575.84
$ 4,966.43
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: HW686 Contract File
FROM: Skylar Murphy, Contract Manager
SUBJECT: Haines City Quality Cleaners DC010A-1;
Construction and Re-piping
DATE: July 7, 2022
This Task Assignment Change Order authorizes Professional Service Industries, Inc. (PSI) to complete construction and re-piping activities in accordance with the PSI scope of work, bid documentation, cost estimate, and schedule received on July 6, 2022.
Based on neighboring site redevelopment, PSI is performing construction observations, redesign, and re-piping of an SVE line to protect the integrity of the system and maintain the relationship with the RPO.
The cost addition is $5,475.99. 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 $8,913.16 with 85 hours.
FDEP COST ESTIMATEContractor: Professional Service Industries, Inc. (Intertek-PSI)
Date: 7/5/2022
Task #: DC 010 A CO-1 SubTask 1 Project Management SubTask 6
Site: Haines City Quality Cleaners, ERIC_5357 SubTask 2 Construction Plan Review, Site Visit SubTask 7
Activity/Phase: Construction Plans Review SubTask 3 Construction Observations SubTask 8
Project Manager: Nana Westmark SubTask 4 SVE re-piped SubTask 9
SubTask 5 SubTask 10
Totals 1 2 3 4 5 6 7 8 9 10 Labor Rate Category
$55.84 Project Manager 6 5.6 $0.00 Principal Consultant 0 0 0 0 0 0 0 0 0 0
$62.64 Senior Engineer, MR 2 2 0 0 0 0 0 0 0 0 $55.84 Senior Geologist, NW 0 0 0 0 0 0 0 0 0 0
$0.00 Senior Scientist 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 $0.00 Certified Hazardous Materials Manager 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 $0.00 Project Manager 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 $38.20 Project Engineer, IK 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 $33.99 Project Engineer, SJ 15 6 1 8 0 0 0 0 0 0 $32.44 Project Scientist, SB 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 $29.62 Project Scientist, RF 0 0 0 0 0 0 0 0 0 0
$0.00 QA Officer 0 0 0 0 0 0 0 0 0 0 $30.59 Remediation Specialist, RH 34 6 14 14 0 0 0 0 0 0 $24.84 GIS / CAD Specialist, CF 2 0 0 2 0 0 0 0 0 0
$0.00 Staff Engineer 0 0 0 0 0 0 0 0 0 0 $0.00 Staff Geologist 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 $30.30 Environmental Specialist, CC 13 0 0 13 0 0 0 0 0 0 $21.21 Environmental Specialist, MZ 13 0 0 13 0 0 0 0 0 0 $20.81 Administrative Assistant, BM 0 0 0 0 0 0 0 0 0 0
$0.00 0 0 0 0 0 0 0 0 0 0 Total Hours 85 6 14 15 50 0 0 0 0 0 0
Direct Labor $2,705.79 $311.29 $512.76 $462.25 $1,419.49 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Overhead 151.02% $4,086.28 $470.11 $774.37 $698.09 $2,143.71 $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 $6,792.07 $781.40 $1,287.13 $1,160.34 $3,563.20 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
REV: 02/03 CEF Intertek-PSI Page 1
Task #: DC 010 A CO-1 SubTask 1 Project Management SubTask 6
Site: Haines City Quality Cleaners, ERIC_5357 SubTask 2 Construction Plan Review, Site Visit SubTask 7
Activity/Phase: Construction Plans Review SubTask 3 Construction Observations SubTask 8
Project Manager: Nana Westmark SubTask 4 SVE re-piped SubTask 9
SubTask 5 SubTask 10
Totals 1 2 3 4 5 6 7 8 9 10
Travel Vehicle Rental $480.00 $120.00 $120.00 $240.00 $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 $480.00 $120.00 $120.00 $240.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Subcontractor (Equipment Procurement) The Home Depot $301.74 $0.00 $0.00 $301.74 $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 $301.74 $0.00 $0.00 $301.74 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Procurement Fee $30.17 $0.00 $0.00 $30.17 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $331.91 $0.00 $0.00 $331.91 $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 $120.00 $40.00 $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) $510.00 $0.00 $75.00 $435.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Field Expenses $630.00 $40.00 $115.00 $475.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Subtotal $8,233.98 $781.40 $1,447.13 $1,395.34 $4,610.11 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Completion Fee $679.20 $78.14 $128.71 $116.03 $356.32 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Total Estimated Cost $8,913.18 $859.54 $1,575.84 $1,511.37 $4,966.43 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
TA 3,437.20$ 349.99$ 1,575.84$ 1,511.37$ $0.00
Delta 5,475.99$ 509.53$ $0.00 $0.00 4,966.46$ CEF Rounding Error 0.02$ 0.02$ $0.00 $0.00 $0.00
$8,913.16 $859.52 1,575.84$ 1,511.37$ $4,966.43
REV: 02/03 CEF Intertek-PSI Page 2
LEVEL OF EFFORT/EXPENSE WORKSHEET
SITE : Haines City Quality Cleaners, ERIC_5357 SubTask 2 Construction Plan Review, Site Visit
DATE: 7/5/2022
LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON
STAFF-TITLE WORK DESCRIPTION HOURS
Senior Engineer, M Rothenburg Technical oversight 2
Project Engineer, S Jordan Obtain permitted redevelopment plans, review plans 4 Discuss plans with contractor and FDEP 2
Remediation Specialist, R Hanson Travel (round trip) 3 Site visit 3
TOTAL LABOR 14
VEHICLE TYPE RATE UNIT USEAGE
$0.00
Equipment Van / Truck $120.00 day 1 $120.00
$0.00
TOTAL VEHICLE $120.00
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
Expendables $40.00 day 1 $40.00
TOTAL EQUIPME $40.00
FINAL --7/24/96
SubTask 3 Construction Observations
DATE: 7/5/2022
LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON
STAFF-TITLE WORK DESCRIPTION HOURS
Project Engineer, S Jordan Review Field Deliverable 1
Remediation Specialist, R Hanson Travel (round trip) 3 Observations of construction during parking space rebuild by others 8 Provide Field Deliverable 3
TOTAL LABOR 15
VEHICLE TYPE RATE UNIT USEAGE
$0.00
Equipment Van / Truck $120.00 day 1 $120.00
$0.00
TOTAL VEHICLE $120.00
PER DIEM STAFF RATE UNIT USEAGE
$0.00
$0.00 $0.00 $0.00
TOTAL PER DIEM $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 $0.00 $0.00 $0.00
TOTAL LAB $0.00
EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS
$0.00 Construction/O&M supplies $75.00 day 1 $75.00
$0.00 $0.00
Expendables $40.00 day 1 $40.00 $0.00 $0.00
TOTAL EQUIPMENT $115.00
SubTask 4 SVE re-piped
DATE: 7/5/2022
LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON
STAFF-TITLE WORK DESCRIPTION HOURS
Project Engineer, S Jordan Evaluate site conditions based on new information 4 Develop field deliverable, sign, seal plans 4
Remediation Specialist, R Hanson Travel (round trip) 3
On-site repiping 8 Generate photo log of site conditions for deliverable 3
Environmental Specialist, M Zilske Travel (round trip) 3 On-site repiping 10
Environmental Specialist, C Cummins Travel (round trip) 3
On-site repiping 10
GIS, CAD Specialist, C Fugate generate drawing of new construction 2
TOTAL LABOR 50
VEHICLE TYPE RATE UNIT USEAGE
$0.00
Equipment Van / Truck $120.00 day 2 $240.00
$0.00
TOTAL VEHICLE $240.00
PER DIEM STAFF RATE UNIT USEAGE
$0.00
$0.00
TOTAL PER DIEM $240.00
SUBCONTRACTOR EQUIPMENT PROCUREMENT
$0.00 The Home Depot Piping, PVC glue, various PVC gaskets $301.74 1 $301.74
$0.00 $301.74
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 $0.00 $0.00 $0.00
TOTAL LAB $0.00
EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS
$0.00 Construction/O&M supplies $75.00 day 1 $75.00 Construction Kit $360.00 day 1 $360.00
$435.00 $0.00 Expendables $40.00 day 1 $40.00
$0.00 $0.00
TOTAL EQUIPMENT $475.00
TOTAL EQUIPMENT PROCUREMENT
Task #: DC 010 A Delta SubTask 1 Project Management SubTask 6
Site: Haines City Quality Cleaners, ERIC_5357 SubTask 2 Construction Plan Review, Site Visit SubTask 7
Activity/Phase: Construction Plans Review SubTask 3 Construction Observations SubTask 8
Project Manager: Nana Westmark SubTask 4 SVE re-piped SubTask 9
SubTask 5 SubTask 10
Totals 1 2 3 4 5 6 7 8 9 10 Labor Rate Category
$55.84 Project Manager 3 3.3 $0.00 Principal Consultant 0 0 0 0 0 0 0 0 0 0
$62.64 Senior Engineer, MR 0 0 0 0 0 0 0 0 0 0 $55.84 Senior Geologist, NW 0 0 0 0 0 0 0 0 0 0
$0.00 Senior Scientist 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 $0.00 Certified Hazardous Materials Manager 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 $0.00 Project Manager 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 $38.20 Project Engineer, IK 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 $33.99 Project Engineer, SJ 8 0 0 8 0 0 0 0 0 0 $32.44 Project Scientist, SB 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 $29.62 Project Scientist, RF 0 0 0 0 0 0 0 0 0 0
$0.00 QA Officer 0 0 0 0 0 0 0 0 0 0 $30.59 Remediation Specialist, RH 14 0 0 14 0 0 0 0 0 0 $24.84 GIS / CAD Specialist, CF 2 0 0 2 0 0 0 0 0 0
$0.00 Staff Engineer 0 0 0 0 0 0 0 0 0 0 $0.00 Staff Geologist 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 $30.30 Environmental Specialist, CC 13 0 0 13 0 0 0 0 0 0 $21.21 Environmental Specialist, MZ 13 0 0 13 0 0 0 0 0 0 $20.81 Administrative Assistant, BM 0 0 0 0 0 0 0 0 0 0
$0.00 0 0 0 0 0 0 0 0 0 0 Total Hours 53 3 0 0 50 0 0 0 0 0 0
Direct Labor $1,604.02 $184.53 $0.00 $0.00 $1,419.49 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Overhead 151.02% $2,422.39 $278.68 $0.00 $0.00 $2,143.71 $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 $4,026.41 $463.21 $0.00 $0.00 $3,563.20 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Task #: DC 010 A Delta SubTask 1 Project Management SubTask 6
Site: Haines City Quality Cleaners, ERIC_5357 SubTask 2 Construction Plan Review, Site Visit SubTask 7
Activity/Phase: Construction Plans Review SubTask 3 Construction Observations SubTask 8
Project Manager: Nana Westmark SubTask 4 SVE re-piped SubTask 9
SubTask 5 SubTask 10
Totals 1 2 3 4 5 6 7 8 9 10
Travel Vehicle Rental $240.00 $0.00 $0.00 $240.00 $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 $0.00 $240.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Subcontractor (Equipment Procurement) The Home Depot $301.74 $0.00 $0.00 $301.74 $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 $301.74 $0.00 $0.00 $301.74 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Procurement Fee $30.17 $0.00 $0.00 $30.17 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $331.91 $0.00 $0.00 $331.91 $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 $40.00 $0.00 $0.00 $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) $435.00 $0.00 $0.00 $435.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Field Expenses $475.00 $0.00 $0.00 $475.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Subtotal $5,073.32 $463.21 $0.00 $0.00 $4,610.11 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Completion Fee $402.64 $46.32 $0.00 $0.00 $356.32 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Total Estimated Cost $5,475.96 $509.53 $0.00 $0.00 $4,966.43 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
SubTask 2 Construction Plan Review, Site Visit
DATE: 7/5/2022
LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON
STAFF-TITLE WORK DESCRIPTION HOURS
Senior Engineer, M Rothenburg Technical oversight 2 0
Project Engineer, S Jordan Obtain permitted redevelopment plans, review plans 4 0 Discuss plans with contractor and FDEP 2 0
Remediation Specialist, R Hanson Travel (round trip) 3 0 Site visit 3 0
TOTAL LABOR 0
VEHICLE TYPE RATE UNIT USEAGE
$0.00
Equipment Van / Truck $120.00 day 0 $0.00
$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
Expendables $40.00 day 0 $0.00
TOTAL EQUIPME $0.00
SubTask 3 Construction Observations
DATE: 7/5/2022
LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON
STAFF-TITLE WORK DESCRIPTION HOURS
Project Engineer, S Jordan Review Field Deliverable 1 0
Remediation Specialist, R Hanson Travel (round trip) 3 0 Observations of construction during parking space rebuild by others 8 0 Provide Field Deliverable 3 0
TOTAL LABOR 0
VEHICLE TYPE RATE UNIT USEAGE
$0.00
Equipment Van / Truck $120.00 day 0 $0.00
$0.00
TOTAL VEHICLE $0.00
PER DIEM STAFF RATE UNIT USEAGE
$0.00
$0.00 $0.00 $0.00
TOTAL PER DIEM $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 $0.00 $0.00 $0.00
TOTAL LAB $0.00
EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS
$0.00 Construction/O&M supplies $75.00 day 0 $0.00
$0.00 $0.00
Expendables $40.00 day 0 $0.00 $0.00 $0.00
TOTAL EQUIPMENT $0.00
SubTask 4 SVE re-piped
DATE: 7/5/2022
LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON
STAFF-TITLE WORK DESCRIPTION HOURS
Project Engineer, S Jordan Evaluate site conditions based on new information 4 Develop field deliverable, sign, seal plans 4
Remediation Specialist, R Hanson Travel (round trip) 3
On-site repiping 8 Generate photo log of site conditions for deliverable 3
Environmental Specialist, M Zilske Travel (round trip) 3 On-site repiping 10
Environmental Specialist, C Cummins Travel (round trip) 3
On-site repiping 10
GIS, CAD Specialist, C Fugate generate drawing of new construction 2
TOTAL LABOR 50
VEHICLE TYPE RATE UNIT USEAGE
$0.00
Equipment Van / Truck $120.00 day 2 $240.00
$0.00
TOTAL VEHICLE $240.00
PER DIEM STAFF RATE UNIT USEAGE
$0.00
$0.00
TOTAL PER DIEM $240.00
SUBCONTRACTOR EQUIPMENT PROCUREMENT
$0.00 The Home Depot Piping, PVC glue, various PVC gaskets $301.74 1 $301.74
$0.00 $301.74
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 $0.00 $0.00 $0.00
TOTAL LAB $0.00
EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS
$0.00 Construction/O&M supplies $75.00 day 1 $75.00 Construction Kit $360.00 day 1 $360.00
$435.00 $0.00 Expendables $40.00 day 1 $40.00
$0.00 $0.00
TOTAL EQUIPMENT $475.00
TOTAL EQUIPMENT PROCUREMENT
FDEP COST ESTI MATEContractor: Professional Service Industries, Inc. (Intertek-PSI)
Date: 4/15/2022
Task #: SubTask 1 Project Management SubTask 6
Site: Haines City Quality Cleaners, ERIC_5357 SubTask 2 Construction Plan Review, Site Visit SubTask 7
Activity/Phase: Construction Plans Review SubTask 3 Construction Observations SubTask 8
Project Manager: Nana Westmark SubTask 4 SubTask 9
SubTask 5 SubTask 10
Totals 1 2 3 4 5 6 7 8 9 10 Labor Rate Category
$55.84 Project Manager 2 2.3 $0.00 Principal Consultant 0 0 0 0 0 0 0 0 0 0
$62.64 Senior Engineer, MR 2 2 0 0 0 0 0 0 0 0 $55.84 Senior Geologist, NW 0 0 0 0 0 0 0 0 0 0
$0.00 Senior Scientist 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 $0.00 Certified Hazardous Materials Manager 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 $0.00 Project Manager 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 $38.20 Project Engineer, IK 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 $33.99 Project Engineer, SJ 7 6 1 0 0 0 0 0 0 0 $32.44 Project Scientist, SB 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 $29.62 Project Scientist, RF 0 0 0 0 0 0 0 0 0 0
$0.00 QA Officer 0 0 0 0 0 0 0 0 0 0 $30.59 Remediation Specialist, RH 20 6 14 0 0 0 0 0 0 0 $24.84 GIS / CAD Specialist, CF 0 0 0 0 0 0 0 0 0 0
$0.00 Staff Engineer 0 0 0 0 0 0 0 0 0 0 $0.00 Staff Geologist 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 $30.30 Environmental Specialist, CC 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 $20.81 Administrative Assistant, BM 0 0 0 0 0 0 0 0 0 0
$0.00 0 0 0 0 0 0 0 0 0 0 Total Hours 31 2 14 15 0 0 0 0 0 0 0
Direct Labor $1,101.76 $126.75 $512.76 $462.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Overhead 151.02% $1,663.88 $191.42 $774.37 $698.09 $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 $2,765.64 $318.17 $1,287.13 $1,160.34 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
FDEP COST ESTI MATEContractor: Professional Service Industries, Inc. (Intertek-PSI)
Date: 4/15/2022
Task #: SubTask 1 Project Management SubTask 6
Site: Haines City Quality Cleaners, ERIC_5357 SubTask 2 Construction Plan Review, Site Visit SubTask 7
Activity/Phase: Construction Plans Review SubTask 3 Construction Observations SubTask 8
Project Manager: Nana Westmark SubTask 4 SubTask 9
SubTask 5 SubTask 10
Totals 1 2 3 4 5 6 7 8 9 10
Travel Vehicle Rental $240.00 $120.00 $120.00 $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 $120.00 $120.00 $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
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 $40.00 $40.00 $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) $75.00 $0.00 $75.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Field Expenses $155.00 $40.00 $115.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Subtotal $3,160.64 $318.17 $1,447.13 $1,395.34 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Completion Fee $276.56 $31.82 $128.71 $116.03 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Total Estimated Cost $3,437.20 $349.99 $1,575.84 $1,511.37 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
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:
Haines City ERIC_5357
HW686 Professional Service Industries, Inc. (Intertek-PSI)
DC 010 A 1
Current tenant is planning new construction which will interfere with the existing SVE lines. FDEP has agreed to move the SVE lines, and PSI has an immediate opportunity to perform this work today. Labor, materials (new PVC) and equipment to place SVE underground.
Labor, equipment, and materials to re-construct trench to place SVE lines to the SVE system.
$ 8,000.00
Nana G Westmark Digitally signed by Nana G Westmark Date: 2022.05.13 08:25:16 -04'00'
Walsta Jean-Baptiste Digitally signed by Walsta Jean- Baptiste Date: 2022.05.13 08:38:16 -04'00'
William E.
Burns, Jr.
Digitally signed by William E.
Burns, Jr.
Date: 2022.05.13 08:43:01 -04'00'
Sent: Friday, May 13, 2022 6:51 AM To: Murphy, Skylar L <Skylar.L.Murphy@FloridaDEP.gov> Cc: Jean-Baptiste, Walsta <Walsta.JeanBaptiste@FloridaDEP.gov>; Huckaby, Robert <Robert.Huckaby@FloridaDEP.gov>; Scott Jordan <scott.jordan@intertek.com> Subject: Haines City re-piping / for today? Pls respond Importance: High
EXTERNAL MESSAGE
This email originated outside of DEP. Please use caution when opening attachments, clicking links, or responding to this email.
Good Morning – I apologize for sending this so early, but we have availability today to re-do the piping at Haines City (Enterprise Car Rental place in Haines City that is re-doing their parking spaces and we have agreed to move the piping to allow their construction to continue).
One of our projects got canceled last night and we have 3 guys available today. Otherwise, we’ll probably have to wait for another month.
We discussed this at the Site Review Meeting on Tuesday and the only concern as I recall was that Robert wanted us to review the elevation of the piping.
If you can do this pretty quickly, I’ll send our folks over there now.
Kind Regards, Nana Westmark, PG, CHMM Senior Geologist / Principal Consultant Building & Construction Intertek-PSI
Please Note: As of October 12, 2018, my email address will change to:
Nana.Westmark@intertek.com.
Direct 813 – 886 – 1075 Ext 219 Mobile 813 - 267 - 2519 Office 813 – 886 – 1075 Email Nana.Westmark@intertek.com Skype Nana.Westmark.Intertek www.intertek.com/building [gcc02.safelinks.protection.outlook.com] [gcc02.safelinks.protection.outlook.com] [secure-web.cisco.com] mailto:Skylar.L.Murphy@FloridaDEP.gov mailto:Walsta.JeanBaptiste@FloridaDEP.gov mailto:Robert.Huckaby@FloridaDEP.gov mailto:scott.jordan@intertek.com mailto:Nana.Westmark@intertek.com mailto:Nana.Westmark@intertek.com 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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 bas s, 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.
HW686
DC010A Completion October 24, 2022
This Task Assignment authorizes Professional Service Industries, Inc. (PSI) to conduct construction observations at the Haines City Quality Cleaners in accordance with the PSI scope of work, cost estimate, and schedule received on April 15, 2022.
Skylar Murphy 850-245-8795 Contractor Professional Service Industries, Inc. (Inertek-PSI) Contractor
Contractor Nana G. Westmark Contractor 813-886-1075
ERIC_5357
511 Haines City Mall Haines City, Polk County, Florida
Haines City Quality Cleaners
Contractor Contractor
✔ $ 3,437.20
$ 3,437.20
Scope of Work
Professional Service Industries, Inc. (Inertek-PSI) Contractor Nana Westmark
Senior Geologist / Principal Consultant
5/6/2022
Nana Westmark Digitally signed by Nana Westmark Date: 2022.05.06 11:14:03 -04'00'
William E. Burns, Jr.
William E. Burns, Jr. Digitally signed by William E. Burns, Jr.
Date: 2022.05.06 11:01:36 -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
Subtask 2: Construction plan review/ site visit documentation.
05/30/2022
Subtasks 1 & 3: Construction Observation doumentation. Project management.
07/20/2022
Subtask 2: Submittal and FDEP approval of the Construction plan review/ site visit documentation $ 1,575.84
Subtasks 1 & 3: Submittal and FDEP approval of the Construction Observation documentation. Project management. $ 1,861.36
$ 3,437.20
HW686
DC010A
| HW686 DC010A-1 TACO.pdf |
| HW686 DC010A-1 TACO.pdf |
| HW686 DC010A-1 TACO.pdf |
| HW686 DC010A-1 TACO.pdf |
HW686 NS DC010A-1.pdf
| NEW LOE CEF.pdf |
| Cost Estimate |
| 2 Cons Plan Review, Site visit |
| 3 Construction Oversight |
| 4 Re-piping |
| Delta LOE CEF.pdf |
| Cost Estimate |
| 2 Cons Plan Review, Site visit |
| 3 Construction Oversight |
| 4 Re-piping |
| HW686 DC010A-1 TACO |
| Original CEF.pdf |
| Cost Estimate |
| WCD Capture.pdf |
| HW686 DC010A-1 TACO |
| HW686 DC010A-1 TACO |
| Receipts for SVE repair.pdf |
| HW686 DC010A-1 TACO |
| Old TA.pdf |
File details come from the government source that posted it. Updated .