CN-370000-HW687-DC009A.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. 8/26/2020

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

DC009A Completion September 30, 2022

This task assignment authorizes costs for groundwater sampling & associated reporting, along with equipment costs, waste handling & disposal and sample shipping & analysis costs. The total cost for this TA is $6,622.87 with 47.53 hours of labor. All costs are fixed unit rate.

Dean Cox 850-245-8969 Contractor Contractor

Contractor Contractor

Contractor Contractor

Contractor

Terracon Consultants, Inc.

Terracon Consultants, Inc.

Donna Cline 813-321-0340

ERIC_4928

759 S. Federal Highway, Suite 314 Stuart

Comet Cleaners

✔ $ 6,622.87

$ 6,622.87

Scope of Work

Donna Cline

Senior Remediation Engineer

5/20/22

William E. Burns, Jr.

William E. Burns, Jr. Digitally signed by William E. Burns, Jr.

Date: 2022.05.18 08:21:46 -04'00'

N/A

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

WCP TAFORM 04-2017

Contract Number:

Task Assignment #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

Groundwater Monitoring Report 06/30/2022

FDEP approval of Groundwater Monitoring Report (Subtask 1 Project Management and Subtask 2 Groundwater Monitoring & Reporting) $ 6,622.87

$ 6,622.87

HW687

DC009A

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 Interim Secretary

Memorandum

TO: HW687 Contract File FROM: Dean Cox, Contract Manager SUBJECT: Comet DC009A Groundwater Sampling (ERIC_4928)

DATE: 5/17/2022

This task assignment authorizes costs for groundwater sampling & associated reporting, along with travel & equipment costs, waste handling & disposal and sample shipping & analysis costs. The total cost for this TA is $6,622.87 with 47.53 hours of labor. All costs are fixed unit rate.

Labor hours were reduced by 9.27 hours from the original proposal, with an associated $1,488.07 reduction in cost.

This TA serves as an annual NAM sampling update. Only one well was above CTLs in the previous NAM sampling event. The facility is closed. The site access agreement was verified as valid.