CN-370000-HW687-BF03ACO1.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.

BF03A 1 HW687

This Task Assignment Change Order authorizes a time extension only, for the task assignment completion date and deliverable dates.

Megan Johnson 850.245.8994 Contractor Contractor

Contractor Contractor

Contractor

Terracon Consultants, Inc.

Shawn Ouellette 561.689.4299

ERIC_18360

Broward County School Board Property-Plantation

✔ $ 8,533.37

$ 0.00 $ 8,533.37 Completion

Completion✔ 07/14/2023 09/15/2023 63

✔ 1 1 1

Jennifer Farrell

Digitally signed by Jennifer Farrell Date: 2023.07.11 14:38:43 -04'00'

N/A

Cline, Donna L Typewriter Donna Cline Senior Remediation Engineer

7/12/23

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

BF03A

$ 8,533.37

File Review Letter of Findings

QAPP/Work Plan and HASP: Project Management

Department approval of File Review Letter of Findings (Subtask 2)

Department approval of Project Management and QAPP/Work Plan and HASP (Subtasks 1 and 3)

07/19/2023

08/16/2023

$ 4,699.25

$ 3,834.12 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: July 11, 2023

SUBJECT: Negotiation Summary – SRP18

Task Assignment (TA) Change Order #1 – BF03A-1 Broward County School Board Property – ERIC_18360 File Review Letter of Findings, QAPP/Workplan and HASP

This Task Assignment Change Order extends the Task Assignment completion date and the deliverable dates. Specific changes are detailed below:

• The contractor requested a two-month time extension because they are waiting to receive additional assessment data from the responsible party to finalize the path forward report.

There is no change to the original cost of $8533.37 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

BF03A Completion July 14, 2023

The Department approves this Task Assignment (TA) based upon the Cost Proposal and Level of Effort (CP/LOE) to prepare a File Review Letter of Findings and a QAPP/Workplan and HASP submitted to the Department on April 13, 2023, by Terracon Consultants, Inc., for the below referenced site. The final deliverable will be a QAPP/Workplan and HASP received by the Department no later than June 14, 2023.

Megan Johnson 850.245.8994 Contractor Terracon Consultants, Inc. Contractor

Contractor Shawn Ouellette Contractor 561.689.4299

ERIC_18360

SE Corner of Broward Blvd. and South Hiatus Road, Broward County

Broward County School Board Property - Plantation

Contractor Contractor

✔ $ 8,533.37

$ 8,533.37

Scope of Work

Terracon Consultants, Inc.

Contractor Donna Cline, P.E.

Senior Remediation Engineer

Jennifer Farrell

Digitally signed by Jennifer Farrell Date: 2023.04.18 08:36:00 -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

File Review Letter of Findings 05/17/2023

QAPP/Work Plan and HASP; Project Management 06/14/2023

Department approval of File Review Letter of Findings (Subtask 2) $ 3,834.12

Department approval of Project Management and QAPP/Work Plan and HASP (Subtasks 1 and 3) $ 4,699.25

$ 8,533.37

HW687

BF03A