CN-370000-HW686-DC14BCO3.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.

DC014B 3 HW686

Ben Grubbs 8502458992 Professional Service Industries, Inc. (Intertek-PSI)

Joshua Newell 8138861075

ERIC_4750

Classic Cleaners

$ 99,384.15 $ 99,384.15

$ 99,384.15 $ 99,384.15

05/24/2024 07/30/2024 67

1 1

Professional Service Industries, Inc. (Intertek-PSI)

Nana Westmark

Senior Geologist

Nana G Westmark Digitally signed by Nana G Westmark Date: 2024.04.15 11:47:01 -04'00'

Teresa Booeshaghi

Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2024.04.01 09:01:37 -04'00'

4/1/2024

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

From: Nana Westmark To: Grubbs, Benjamin Cc: Joshua Newell Subject: Classic Cleaners ERIC_4750 DC014B time extension request Date: Wednesday, March 27, 2024 11:03:32 Attachments: image001.png

EXTERNAL MESSAGE

This email originated outside of DEP. Please use caution when opening attachments, clicking links, or responding to this email.

Good Morning Ben- PSI is working on the Classic Cleaners ERIC_4750 Site Assessment in Tampa. We respectfully request a time extension for DC014B. This would be the CO-3 due to

- drillers available initially, and now due to Right of Way permits taking longer than anticipated.

We worked with Breck to identify appropriate locations for new wells, and we needed to go outside the property boundaries. We are currently awaiting the permit approval so a 60 day time extension would be helpful.

TA DC014B – please extend due date to 7/30/2024.

Kind Regards, Nana Westmark, PG, CHMM Senior Geologist / Principal Consultant Building & Construction Intertek-PSI

Please Note: My email address has changed to: Nana.Westmark@intertek.com.

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]

Intertek-PSI 5801 Benjamin Center Drive, Suite 112 Tampa, Florida 33634

Total Quality. Assured.

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.

DC014B 2 HW686

This Change Order authorizes a time extension to allow for the completion of deliverables.

Patrick McGrane 850-245-8899 Contractor Professional Service Industries, Inc. (Intertek-PSI) Contractor

Contractor Nana G. Westmark Contractor 813-886-1075

ERIC_4750

Classic Cleaners

$ 99,384.15 $ 99,384.15

$ 99,384.15 $ 99,384.15

Completion Completion 03/20/2024 05/24/2024 65

1 1 2

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

Nana Westmark

Senior Geologist / Principal Consultant

Nana G Westmark Digitally signed by Nana G Westmark Date: 2023.12.19 13:38:50 -05'00'

Jennifer Farrell

Digitally signed by Jennifer Farrell Date: 2023.12.18 13:20:39 -05'00'

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

DC014B

$ 99,384.15

Subtask 2 - GPR Field Notes, Survey Notes & Lab Results of Well Sampling

Subtask 3 - Field Logs AND Lab Results

Subtasks 1 & 4 - Project Management AND Site Assessment Report which include IDW manifests

Subtask 2 - Submittal and FDEP approval of the GPR Field Notes, Survey Notes & Lab Results of Well Sampling

Subtasks 1 & 4 - Submittal and FDEP approval of the Site Assessment Report which include IDW manifests AND Project Management

Subtask 3 - Submittal and FDEP approval of the Field Logs AND Lab Results

05/15/2023

10/10/2023

05/03/2024

$ 72,284.07

$ 10,446.45

$ 16,653.63