CN-370000-HW686-DC19BCO1.pdf

PDF 1 MB Posted Dec 21, 2021

Attached to: Master Agreement FL|HW686|26652fe61cf76d14a6798f2369f5dddb
Contract number: HW686
Issued by: Florida

About this file

Written by GovTribe AI · May 1, 2026

This document is a Task Assignment Change Order (TACO) issued by the State of Florida Department of Environmental Protection (FDEP) to Professional Service Industries, Inc. (Intertek-PSI) for services at the Rene Cleaners site located at 2710 Blanding Boulevard in Middleburg, Clay County, Florida. The underlying contract number is HW686, with the task assignment number DC019B. The contract is managed by Mary Uribe on behalf of FDEP and Joshua Newell representing the contractor.

The task assignment involves soil assessment and groundwater sampling and analysis services. This change order represents a cost reduction of $1,369.00, reducing the total task amount from $27,764.23 to $26,395.23. The cost reduction results from laboratory modifications within Subtask 2, specifically: removal of 10 halocarbons analysis, addition of one Encore Sampler, removal of 15 TCLP/SPLP bottle extractions, and conversion of TCLP samples from aqueous to non-aqueous testing. The deliverable is a Supplemental Site Assessment Report with IDW manifests due August 29, 2025. The task completion date remains October 31, 2025. Payment is due upon submittal and FDEP approval of the Supplemental Site Assessment Report with IDW manifests in a single invoice for the total contracted amount of $26,395.23.

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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. 8/17/2020

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.

DC019B 1 HW686

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

Contractor Joshua Newell Contractor 863-712-4342

ERIC_4266

Rene Cleaners

✔ $ 26,395.23 $ 27,764.23

$ 26,395.23 $ 27,764.23 ✔ Completion

Completion 10/31/2025 10/31/2025 0

1 1

Contractor Douglas Coleman PMP, CHMM, REM

Contract Manager

Douglas Coleman Digitally signed by Douglas Coleman Date: 2025.09.09 09:10:28 -04'00'

Mubeen Darji

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

Date: 2025.09.08 14:34:16 -04'00'

Cost reduction - removal of some SPLP samples and adjusting TCLP samples from aqueous to non aqueous.

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

DC019B

$ 26,395.23

Subtask 1: Project Management Subtask 2 & 3: Supplemental Site Assessment Report

Subtask 1, 2, & 3: Submittal and DEP approval of the SSAR w/ IDW manifests.

08/29/2025

$ 26,395.23

FFLORIDA DEPARTMENT OF

EEnvironmental Protection

Bob Martinez Center 2600 Blair Stone Road

Tallahassee, FL 32399-2400

Ron DeSantis Governor

Alexis A. Lambert Secretary

Memorandum

TO:

FROM:

SUBJECT:

DATE:

ERIC_

Cleaners

Mary Uribe, Project Manager

Negotiation Summary

HW686 DC0

Total task amount $ . PSI’s time, labor, and subcontractor costs for these activities have been reviewed and are appropriate. The level-of-effort and cost estimate are reasonable for the scope of services. Final deliverable due date is

. Task completion date is

F D E P

C O S T

E S T I M A T E

C on tra ct or

Pr of es si on al

S er vi ce

In du st rie s, In c.

(I nt er te k-

I) at e:

Ta sk

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Jo sh

N ew el l as k

Su bT as k

To ta ls

La bo r R at e

C at eg or y $4

Pr oj ec t M an ag er

.8 $6

Pr in ci pa l C on su lta nt

Se ni or E ng in ee r, G R

$5 8.

Se ni or

G eo lo gi st , N

Pr oj ec t E ng in ee r, JN

Pr oj ec t S ci en tis t, SL

Q A

O ffi ce r

$0 .0

R em ed ia tio n Sp ec ia lis t, R H

$3 4.

S pe ci al is t, D G

$2 5.

St af f S ci en tis t, M

En vi ro nm en ta l S pe ci al is t, C C

$2 8.

En vi ro nm en ta l S pe ci al is t, D

Ad m in is tra tiv e As si st an t, BM

To ta l H ou rs

D ire ct L ab or

$2 ,6

$0 .0

O ve rh ea d

$1 ,1

$4 ,7

$0 .0

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Fr in ge 0.

$0 .0

To ta l L

6, 3.

$1 ,9

$7 ,8

$0 .0

R E V

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I n t e r t e k

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C O S T

E S T I M A T E

C on tra ct or

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$0 .0

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H ot el $1

$1 ,1

$0 .0

To ta l T ra ve l $1

$1 ,6

$0 .0

Su bc on tr ac to r

(E qu ip m en t P ro cu re m t)

W l S up pl ie s

$0 .0

Su bc on tra ct or

S ub to ta l $1

$0 .0

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$1 9.

$0 .0

To ta l S ub co nt ra ct or C os t

$0 .0

Su bc on tr ac to r (S er vi ce s

Pr oc ur em ril lin g (C on ve nt io na l)

$0 .0

D ril lin g

(N on

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l) $0

$0 .0

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L ab or at or y

$0 .0

Su rv ey in g $0

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W $3

$0 .0

U til iti es $0

$0 .0

Su bc on tra ct or S ub to ta l

$0 .0

H an dl in g Fe e $3

$3 2.

$0 .0

To ta l S ub co nt ra ct or

C os t $3

$0 .0

La bo ra to ry

An al yt ic al

C os ts $3

$3 ,5

$0 .0

Fa st T ur na ro un d C ha rg es $0

$0 .0

Sa m pl e Sh ip pi ng $0

$0 .0

To ta l L ab or at or y $3

$3 ,5

$0 .0

Fi el d

Ex pe ns es

Pe rs on al P ro te ct io n $0

$0 .0

Ex pe nd ab le s $1

$0 .0

Eq ui pm en t (

D ril lin g re la te d)

$0 .0

Eq ui pm en t ( An al yt ic al re la te d)

$0 .0

Eq ui pm en t (

W re la te

d) $0

$0 .0

Eq ui pm en t (

O th er

$2 ,3

$0 .0

To ta l F ie ld E xp en se s

$2 ,4

$0 .0

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$2 4, 1.

$1 4, 9.

$0 .0

C om pl et io n Fe e $1

$0 .0

To ta l E st im at ed C os t

$2 6, 5.

$1 5, 3.

$0 .0

R E V

C E F

P S I

I n t e r t e k

P a g

LEVEL OF EFFORT/EXPENSE WORKSHEET

SITE : Rene Cleaners ERIC_4266 SubTask 2 GW & Soil Sampling

DATE:

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Senior Engineer, G Robinson Tenant Notification 1 Technical Oversight 4

Total Hours: 5

Project Engineer, J Newell Profile waste(s) for disposal 2 Oversee IDW transport and disposal 2

Total Hours: 4

Project Scientist, S. Luth Travel (1 round trip) 7 Collect groundwater well supplies 2 Collect groundwater elevations (10 wells) (10 minutes per well) 2 Collect groundwater samples 4 shallow wells @ 1.5 hour per well 6 1 intermediate wells @ 1.5 hour per well 1.5 Drum purge water IDW, label & stage on-site 1 Advance soil boring and collect soil samples 9 Documentation of groundwater sampling & measurements 2 Hotel Travel (3) round trip) 3

Total Hours: 33.5

Staff Scientist, M. Matar Field Event Preparation 2 Travel (1 round trip) 7 Core Drill Slab 10 Advance soil boring and collect soil samples 1 Patch Existing Slab with Cement 4 Drum concrete and soil IDW, label & stage on-site 1 Pick up Tampa / Drop off Sample Kits Altamonte Springs 2 Documentation of soil sampling & measurements 2 Upload Photos, Field Notes, and Sampling Logs to Server 1 Hotel Travel (3) round trip) 3

Total Hours: 33

TOTAL LABOR 75.5

EQUIPMENT ITEM RATE COSTING UNIT USAGE TOTALS

Soil Sampling Kit through Concrete $235.00 day 4 $940.00 Shallow Groundwater Sampling Kit $290.00 day 4 $1,160.00 55-gallon drum $100.00 each 2 $200.00 Expendables $40.00 day 3 $120.00

$120.00

TOTAL EQUIPMENT $2,420.00

RATE COSTING UNIT USEAGE TOTALS

Well Supplies

1 inch pre-packed 5 ft well screen, 10 slot $80.00 each 1 $80.00 5 ft of 1 inch riser $12.25 each 1 $12.25 1 inch locking plug $5.50 each 1 $5.50 Female Thread well point $9.20 each 1 $9.20 concrete mix $7.15 each 2 $14.30 sand $6.80 each 11 $74.80

$196.05

VEHICLE TYPE RATE UNIT USAGE

Equipment Van / Truck $120.00 day 4 $480.00

TOTAL VEHICLE $480.00

PER DIEM STAFF RATE UNIT USAGE

Lodging Groundwater Sampling $150.00 2 person, 3 nights 6 $900.00 Meals Groundwater Sampling $36.00 2 person, 4 days meals 8 $288.00

$0.00

TOTAL PER DIEM $1,188.00

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC IDW

Halocarbons $73.00 30 2 $2,336.00 Encore Sampler $16.00 21 $336.00 TCLP/SPLP Bottle Extraction $45.00 6 $270.00 TCLP Metals $130.00 0 $0.00 TCLP Volatile Organics by GC/MS $205.00 0 $606.00 $0.00 TCLP Semi-volatile organics by GC/MS $250.00 0 $0.00 TCLP Metals $135.00 1 $135.00 TCLP Volatile Organics by GC/MS $210.00 1 $135.00 $210.00 TCLP Semi-volatile organics by GC/MS $260.00 1 $260.00

TOTAL LAB $3,547.00

SUBCONTRACTOR COSTS

NAME PURPOSE UNIT COST

Gulf Coast Vac Trk 2 $150.00 $300.00

Gulf Coast Vac Trk 1 $25.00 $25.00 Gulf Coast Vac Trk 0 $100.00 $0.00

TOTAL $325.00

Per invoice fee IDW transport & disposal per drum

11/21/2024

TOTAL EQUIPMENT PROCUREMENT

EQUIPMENT PROCUREMENT

IDW transport & disposal per drum/profile

Page 3 Final Rene ERIC_4266 Soil Conf. - TACO1 Final

SubTask 3 Data Evaluation and Reporting

DATE:

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Senior Engineer, G Robinson Provide Evaluation and Edits to Report 6 Total Hours: 6

Project Engineer, J Newell Data Reduction / Evaluation 8 Historic Review 2 Draft Report Text 16 Draft Figures and Tables 24 Update Report with Revisions 1 Sign and Seal Report 1

Total Hours: 52

GIS/CADD Specialist, D Grove Create and prepare final figures 8 Total Hours: 8

TOTAL LABOR 66

EQUIPMENT ITEM RATE COSTING UNIT USAGE TOTALS

$0.00

TOTAL EQUIPMENT $0.00

VEHICLE TYPE RATE UNIT USAGE

TOTAL VEHICLE $0.00

PER DIEM STAFF RATE UNIT USAGE

TOTAL PER DIEM

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC IDW

TOTAL LAB $0.00

SUBCONTRACTOR COSTS

NAME PURPOSE UNIT COST

TOTAL $0.00

11/21/2024

Page 4 Final Rene ERIC_4266 Soil Conf. - TACO1 Final

E P

C O S T

E S T I M A T E

C on tra ct or

Pr of es si on al

S er vi ce

In du st rie s, In c.

(I nt er te k-

1/ as k

Pr oj ec t M an ag em en t

Su bT as k

Si te

R en e

C le an er s

_4 as k

G W

S oi l S am pl in g

Su bT as k

Ac tiv ity /P ha se

Si te A ss es sm as k

D at a

Ev al ua tio n an d R ep or tin g

Su bT as k

Pr oj ec t M an ag er

Jo sh

N ew as k

Su bT as k

To ta ls

La bo r R at e

C at eg or y $4

Pr oj ec t M an ag er

Pr in ci pa l C on su lta nt

Se ni or E ng in ee r, G R

$5 8.

Se ni or

G eo lo gi st , N

Pr oj ec t E ng in ee r, JN

Pr oj ec t S ci en tis t, SL

Q A

O ffi ce r

$0 .0

R em ed ia tio n Sp ec ia lis t, R H

$3 4.

S pe ci al is t, D G

$2 5.

St af f S ci en tis t, $3

En vi ro nm en ta l S pe ci al is t, C C

$2 8.

En vi ro nm en ta l S pe ci al is t, D

Ad m in is tra tiv e As si st an t, BM

To ta l H ou rs

D ire ct L

$0 .0

O ve rh ea d

$0 .0

G en

A dm in

$0 .0

Fr in ge 0.

$0 .0

To ta l L

$0 .0

R E V

C E F

P S I

I n t e r t e k

P a g

E P

C O S T

E S T I M A T E

C on tra ct or

Pr of es si on al

S er vi ce

In du st rie s, In c.

(I nt er te k-

1/ as k

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Su bT as k

Si te

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G W

S oi l S am pl in g

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Su bT as k

Pr oj ec t M an ag er

Jo sh

N ew as k

Su bT as k

To ta ls

Tr av el

Ve hi cl e

R en ta l

$0 .0

M ile ag e

C os ts $0

$0 .0

Ai r F ar e $0

$0 .0

Pe r d ie m

H ot el $0

$0 .0

To ta l T ra ve l $0

$0 .0

Su bc on tr ac to r

(E qu ip m en t P ro cu re m

W l S up pl ie s

$0 .0

Su bc on tra ct or

S ub to ta l $0

$0 .0

Pr oc ur em en t F ee

$0 .0

To ta l S ub co nt ra ct or C os t

$0 .0

Su bc on tr ac to r (S er vi ce s

Pr oc ur em ril lin g (C on ve nt io na l)

$0 .0

D ril lin g

(N on

-c on ve nt io na

l) $0

$0 .0

M ob ile

L ab or at or y

$0 .0

Su rv ey in g $0

$0 .0

W $0

$0 .0

U til iti es $0

$0 .0

Su bc on tra ct or S ub to ta l

$0 .0

H an dl in g Fe e $0

$0 .0

To ta l S ub co nt ra ct or

C os t $0

$0 .0

La bo ra to ry

An al yt ic al

C os ts

1, 9.

$0 .0

Fa st T ur na ro un d C ha rg es $0

$0 .0

Sa m pl e Sh ip pi ng $0

$0 .0

To ta l L ab or at or y

1, 9.

$0 .0

Fi el d

Ex pe ns es

Pe rs on al P ro te ct io n $0

$0 .0

Ex pe nd ab le s $0

$0 .0

Eq ui pm en t (

D ril lin g re la te d)

$0 .0

Eq ui pm en t ( An al yt ic al re la te d)

$0 .0

Eq ui pm en t (

W re la te

d) $0

$0 .0

Eq ui pm en t (

O th er

$0 .0

To ta l F ie ld E xp en se s

$0 .0

Su bt ot al

1, 9.

$0 .0

1, 9.

$0 .0

C om pl et io n Fe e $0

$0 .0

To ta l E st im at ed C os t

1, 9.

$0 .0

1, 9.

$0 .0

R E V

C E F

P S I

I n t e r t e k

P a g

SubTask 2 GW & Soil Sampling

DATE:

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Senior Engineer, G Robinson Tenant Notification 0 Technical Oversight 0

Total Hours: 0

Project Engineer, J Newell Profile waste(s) for disposal 0 Oversee IDW transport and disposal 0

Total Hours: 0

Project Scientist, S. Luth Travel (1 round trip) 0 Collect groundwater well supplies 0 Collect groundwater elevations (10 wells) (10 minutes per well) 0 Collect groundwater samples 4 shallow wells @ 1.5 hour per well 0 1 intermediate wells @ 1.5 hour per well 0 Drum purge water IDW, label & stage on-site 0 Advance soil boring and collect soil samples 0 Documentation of groundwater sampling & measurements 0 Hotel Travel (3) round trip) 0

Total Hours: 0

Staff Scientist, M. Matar Field Event Preparation 0 Travel (1 round trip) 0 Core Drill Slab 0 Advance soil boring and collect soil samples 0 Patch Existing Slab with Cement 0 Drum concrete and soil IDW, label & stage on-site 0 Pick up Tampa / Drop off Sample Kits Altamonte Springs 0 Documentation of soil sampling & measurements 0 Upload Photos, Field Notes, and Sampling Logs to Server 0 Hotel Travel (3) round trip) 0

Total Hours: 0

TOTAL LABOR 0

EQUIPMENT ITEM RATE COSTING UNIT USAGE TOTALS

Soil Sampling Kit through Concrete $235.00 day 0 $0.00 Shallow Groundwater Sampling Kit $290.00 day 0 $0.00 55-gallon drum $100.00 each 0 $0.00 Expendables $40.00 day 0 $0.00

$0.00

TOTAL EQUIPMENT $0.00

RATE COSTING UNIT USEAGE TOTALS

Well Supplies

1 inch pre-packed 5 ft well screen, 10 slot $80.00 each 0 $0.00 5 ft of 1 inch riser $12.25 each 0 $0.00 1 inch locking plug $5.50 each 0 $0.00 Female Thread well point $9.20 each 0 $0.00 concrete mix $7.15 each 0 $0.00 sand $6.80 each 0 $0.00

$0.00

VEHICLE TYPE RATE UNIT USAGE

Equipment Van / Truck $120.00 day 0 $0.00

TOTAL VEHICLE $0.00

PER DIEM STAFF RATE UNIT USAGE

Lodging Groundwater Sampling $150.00 2 person, 3 nights 0 $0.00 Meals Groundwater Sampling $36.00 2 person, 4 days meals 0 $0.00

$0.00

TOTAL PER DIEM $0.00

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC IDW

Halocarbons $73.00 -10 0 ($730.00) Encore Sampler $16.00 1 $16.00 TCLP/SPLP Bottle Extraction $45.00 -15 ($675.00) TCLP Metals $130.00 -1 ($130.00) TCLP Volatile Organics by GC/MS $205.00 -1 ($789.00) ($205.00) TCLP Semi-volatile organics by GC/MS $250.00 -1 ($250.00) TCLP Metals $135.00 1 $135.00 TCLP Volatile Organics by GC/MS $210.00 1 ($320.00) $210.00 TCLP Semi-volatile organics by GC/MS $260.00 1 $260.00

TOTAL LAB ($1,369.00)

SUBCONTRACTOR COSTS

NAME PURPOSE UNIT COST

Gulf Coast Vac Trk 0 $150.00 $0.00

Gulf Coast Vac Trk 0 $25.00 $0.00 Gulf Coast Vac Trk 0 $100.00 $0.00

TOTAL $0.00

Per invoice fee IDW transport & disposal per drum

11/21/2024

TOTAL EQUIPMENT PROCUREMENT

EQUIPMENT PROCUREMENT

IDW transport & disposal per drum/profile

Page 3 Delta Rene ERIC_4266 Soil Conf. - Delta

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

DC019B October 31, 2025

Soil assessment and groundwater sampling and analysis.

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

Joshua Newell 863-712-4342

ERIC_4266

2710 Blanding Boulevard Middleburg, Clay County

Rene Cleaners

$ 27,764.23

Scope of Work

Professional Service Industries, Inc. (Intertek-PSI)

Mubeen Darji

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

Date: 2025.01.13 15:24:07 -05'00'

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

File details come from the government source that posted it. Updated May 1, 2026.