CN-370000-HW686-DC15DCO1.pdf
PDF 789 KB Posted
- Contract number
- HW686
- Issued by
- Florida
About this file
This document is a Task Assignment Change Order (TACO) issued by the State of Florida Department of Environmental Protection (DEP) to Professional Service Industries, Inc. (Intertek-PSI) for work at the Quality Cleaners site (ERIC_4771) located at 14837 North Florida Avenue, Tampa, Hillsborough County. The change order amends the original Task Assignment DC015D under Contract Number HW686. The Department's Project Manager is Mary Uribe (850-245-8990), and the Contractor's Project Manager is Joshua Newell (863-712-4342). The contract manager for the contractor is Douglas Coleman, PMP, CHMM, REM.
This TACO is a time extension only, with no changes to compensation. The total task value remains at $12,974.96 on a fixed unit rate basis. The deliverables include two subtasks: Project Management and an Interim Source Removal Plan (ISRP). The original completion date was extended from February 27, 2026 to March 27, 2026, a total extension of 28 days. The contractor must submit invoices upon DEP approval of both the Project Management and ISRP deliverables to receive the full contract amount of $12,974.96. The Level of Effort worksheet details labor costs for 83 hours across multiple staff positions, vehicle use at $120, equipment and expendables totaling $400, with no laboratory, per diem, or subcontractor costs included.
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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:
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.
DC015D 1 HW686
Mary Uribe 8502458990 Contractor Professional Service Industries, Inc. (Intertek-PSI) Contractor
Contractor Joshua Newell Contractor 863-712-4342
ERIC_4771
Quality 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: 2026.01.27 16:01:58 -05'00'
Mubeen Darji
Mubeen Darji, P.E. Digitally signed by Mubeen Darji, P.E.
Date: 2026.01.27 15:22:18 -05'00'
Time Extension for deliverable due date and task completion 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
DC015D
$ 12,974.96
Subtask 1: Project Management Subtask 2: ISRP
Subtask 1: DEP approval of Project Management Subtask 2: DEP approval of ISRP
02/27/2026
$ 12,974.96
LEVEL OF EFFORT/EXPENSE WORKSHEET
SITE : Quality Cleaners ERIC_4771 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 specification 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 Quality Cleaners ERIC_4771 ISR Plan SVE 0552-446333r1
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
DC015D 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_4771
14837 North Florida Avenue Tampa, Hillsborough County
Quality 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: 2025.09.11 09:25:22 -04'00'
Mubeen Darji
Mubeen Darji, P.E. Digitally signed by Mubeen Darji, P.E.
Date: 2025.09.11 08:20:23 -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
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