CN-370000-HW686-DC13CCO1.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.

DC013C 1 HW686

Mary Uribe 8502458990 Contractor Professional Service Industries, Inc. (Intertek-PSI) Contractor

Contractor Joshua Newell Contractor 863-712-4342

ERIC_4721

Palm Cleaners

✔ $ 12,974.96 $ 12,974.96

$ 12,974.96 $ 12,974.96 Completion

✔ Completion 02/27/2026 03/27/2026 28

1 1

Contractor Douglas Coleman PMP, CHMM, REM

Contract Manager

Douglas Coleman Digitally signed by Douglas Coleman Date: 2026.01.23 10:24:38 -05'00'

Mubeen Darji

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

Date: 2026.01.22 11:43:59 -05'00'

Time Extension for Deliverable Due Date

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

DC013C

$ 12,974.96

Subtask 1: Project Management Subtask 2: ISRP

Subtask 1: Project Management Subtask 2: ISRP

02/27/2026

$ 12,974.96

LEVEL OF EFFORT/EXPENSE WORKSHEET

SITE : Palm Cleaners ERIC_4721 SubTask 2 ISR Plan

DATE: 9/5/2025

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Field Activities

Senior Engineer, G Robinson Coordinate with tenant, property owner 2 Review bid documents for subcontractors 2 Review calculations 2 Review text 3 Review tables 1 Review figures 1 Sign and seal documents 1

Total Hours 12

Project Engineer, J Newell Travel to Site, roundtrip 3 Meet on-site with tenant/owner to evaluate equipment locations 3 Evaluate electrical requirements with power company 3 Prepare remediation calculations (SV & AI - flow rates and friction loss) 6 Equipment specifications selection - SVE/AI blowers 8 Prepare ISRP text 12 Develop tables 4

Prepare ISR checklist 2 Develop bid documents for subcontractors 6

Total Hours 59

Project Scientist, J Daugherty Obtain subcontractor quotes 6 Total Hours 6

GIS/CADD Specialist, D Grove Create and prepare final figures 3

Administrative Assistant, B Meynardie Compile documents 3

TOTAL LABOR 83.00

VEHICLE TYPE RATE UNIT USEAGE

$0.00 Equipment Van / Truck $120.00 day 1 $120.00

TOTAL VEHICLE $120.00

PER DIEM STAFF RATE UNIT USEAGE

$0.00 $0.00

TOTAL PER DIEM $0.00

SUBCONTRACTOR COSTS

NAME PURPOSE COST

TOTAL $0.00

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC IDW

$0.00 $0.00

TOTAL LAB $0.00

EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS

$0.00 Expendables $40.00 day 1 $40.00 Construction Test Kit $360.00 day 1 $360.00

#REF!

TOTAL EQUIPMENT $400.00

Develop figures (site plan, treatment system layout, trenching cross sections, well construction details, manifold details, piping and instrumentation diagram (P&ID), fence detail, trailer tie down detail, and equipment layout as needed)

FINAL --7/24/96

Page 4 Palm Cleaners ERIC_4721 ISR Plan SVE 0552-446332r1

FDEP – Palm Dry Cleaners ERIC_4721 PSI Proposal 0552-446332r1

September 5, 2025 www.intertek.com/building

PSI, therefore, has developed this scope of work, cost estimate and level of effort to prepare an ISR Plan consisting of SVE remedial technology with an optional air injection blower if a newly constructed system is recommended.

PROPOSED SCOPE OF WORK

This proposal consists of preparing the Interim Source Removal Plan (Soil Vapor Extraction) at the referenced site.

Specifically, the proposed scope of work consists of the following subtasks:

1. Project Management

This scope is provided for in the template worksheets.

2. Interim Source Removal Plan (ISR Plan)

The design of the ISRP will address VOH concentrations in the soil and will not directly address groundwater quality. The presumptive remedy for remediation of impacted soil at the Palm Dry Cleaners site is soil vapor extraction, based on previous experience, feasibility, implementability, reliability, operations and maintenance (O&M) requirements, and cost. PSI will also coordinate with the building tenant, property management company, and the property owner for suggested locations of piping, lines, and equipment compound.

Calculations will be generated to determine the design, construction details and specifications of the system (number of SVE wells, radius of influence, estimated time to cleanup, etc). Figures will include site plan, treatment system layout, trenching cross sections, well construction details, manifold details, piping and instrumentation diagram (P&ID), fence detail, trailer tie down detail, and equipment layout, as necessary.

The SVE design will include a summary of the MAGS survey. The report will include pertinent information to include a detailed description of the remedial system, operation details, start-up testing, site schedule for O&M, tables summarizing proposed samples and analysis, and itemized cost estimates for project capital, and the implementation schedule. The design will be signed and sealed by a Florida Registered Engineer in accordance with Chapters 471, Florida Statues. The report will incorporate specific recommendations and provide opinions based on professional experience in order to achieve the most efficient endpoints. We understand that the Department’s goal is to achieve aggressive contaminant reduction in an efficient and cost-effective method.

The deliverable and invoice schedule are presented below and are based on receipt of a Task Assignment prior to September 15, 2025.

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.

HW686

DC013C February 27, 2026

SVE Interim Source Removal Plan

Mary Uribe 850-245-8990 Professional Service Industries, Inc. (Intertek-PSI)

Joshua Newell 863-712-4342

ERIC_4721

14616 Livingston Avenue Lutz, Hillsborough County

Palm Cleaners

$ 12,974.96

$ 12,974.96

Scope of Work

Professional Service Industries, Inc. (Intertek-PSI)

Douglas Coleman PMP, CHMM, REM

Contract Manager

Douglas Coleman Digitally signed by Douglas Coleman Date: 2025.09.19 09:15:43 -04'00'

Mubeen Darji

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

Date: 2025.09.11 11:08:58 -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