CN-370000-HW687-BF01BCO1.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:

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.

BF01B 1 HW687

Megan Johnson 850.245.899 Contractor Contractor

Contractor Contractor

Contractor

Terracon Consultants, Inc.

Tom Lewis, P.G. 850.692.7194

ERIC_18047

Former Rose Printing Company

✔ $ 68,527.53 $ 68,527.53

$ 68,527.53 $ 68,527.53 Completion

Completion✔ 06/28/2024 08/16/2024 49

✔ 1 1 1

Terracon Consultants, Inc.

Donna Cline, P.E.

Senior Remediation Engineer Digitally signed by Cline, Donna L DN: cn=Cline, Donna L, ou=General Users, email=Donna.Cline@terracon.com Date: 2024.04.03 13:54:38 -04'00'

Cline, Donna L

Jennifer Farrell

Digitally signed by Jennifer Farrell Date: 2024.04.02 17:58:33 -04'00'

This Task Assignment Change Order authorizes a time extension only, for the task assignment completion date and deliverable due dates. There are no cost changes associated with this TACO.

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

HW687

BF01B

$ 68,527.53

Field Sampling Plan/QAPP and HASP.

Field notes, photographic log, chain of custody, and sampling logs.

Supplemental Site Assessment Report; Project Management.

Department approval of Field Sampling Plan/QAPP and HASP (Subtask 2)

Department approval of Project Management and Supplemental Site Assessment Report (Subtasks 1 and 4)

Department approval of field notes, photographic log, chain of custody, and sampling logs (Subtask 3)

04/03/2024

05/01/2024

06/21/2024

$ 57,297.17

$ 2,058.45

$ 9,171.91 www.FloridaDEP.gov

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: Terracon Consultants, Inc. HW687 Contract File

FROM: Megan Johnson, Contract Manager

DATE: March 29, 2024

SUBJECT: Negotiation Summary – SRP28

Task Assignment (TA) Change Order #1 – TA BF01BC1 Former Rose Printing Company – Site ID # ERIC_18047 Supplemental Site Assessment activities

This Task Assignment Change Order (TACO) extends the Task Assignment completion date and the interim and final deliverable due dates. Specific changes are detailed below:

• FDEP and the contractor agreed on a time extension for the interim and final deliverables due to subcontractor scheduling delays.

There is no change to the original cost of $68,527.53.

http://www.floridadep.gov/

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.

HW687

BF01B Completion June 28, 2024

The Department approves this Task Assignment (TA), based upon the Cost Proposal and Level of Effort (CP/LOE), for Supplemental Site Assessment activities at the below project site, submitted to the Department on January 12, 2024, revised January 25, 2024, by Terracon Consultants, Inc.

Megan Johnson 850-245-8994 Contractor Terracon Consultants, Inc. Contractor

Contractor Tom Lewis, P.G. Contractor 850.692.7194

ERIC_18047

2503 Jackson Bluff Road, Tallahassee, Leon County

Former Rose Printing Company

Contractor Contractor

✔ $ 68,527.53

$ 68,527.53

Scope of Work

Terracon Consultants, Inc.

Contractor Donna Cline, P.E.

Senior Remediation Engineer Digitally signed by Cline, Donna L DN: cn=Cline, Donna L, ou=General Users, email=Donna.Cline@terracon.com Date: 2024.02.01 11:42:41 -05'00'

Cline, Donna L

Jennifer Farrell

Digitally signed by Jennifer Farrell Date: 2024.02.01 11:15:44 -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

QAPP/Work Plan and HASP.

02/12/2024

Field notes, photographic log, chain of custody, and sampling logs.

04/05/2024

Supplemental Site Assessment Report; Project Management.

05/24/2024

Department approval of QAPP/Work Plan and HASP (Subtask 2) $ 2,058.45

Department approval of field notes, photographic log, chain of custody, and sampling logs (Subtask 3) $ 57,297.17

Department approval of Project Management and Supplemental Site Assessment Report (Subtasks 1 and 4) $ 9,171.91

$ 68,527.53

HW687

BF01B