CN-370000-HW687-DC017B.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

DC017B Completion September 30, 2023

This TA authorizes costs for completion of a Site Rehabilitation Completion Report (SRCR). The total cost of this TA is $2,063.66. This entire cost is 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_4789

10055 North Dale Mabry Highway, Tampa (Hillsborough County)

Imperial Cleaners (former)

✔ $ 2,063.66

$ 2,063.66

Scope of Work

Kelly Crain

Kelly Crain Digitally signed by Kelly Crain Date: 2023.05.02 09:50:33 -04'00'

N/A

Cline, Donna L Typewriter Donna Cline

Sr. Remediation Engineer

05/02/23

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

Site Rehabilitation Completion Report, with site assessment & remedial background, data review verifying all media meet 62-780.680(1) RMO I closure, and associated data tables & figures (Subtask 1 Project Management and Subtask 2 SRCR).

05/31/2023

DEP approval of Site Rehabilitation Completion Report, with site assessment & remedial background, data review verifying all media meet 62-780.680(1) RMO I closure, & associated data tables & figs (Subtask 1 Proj Mgmt and Subtask 2 SRCR).

$ 2,063.66

$ 2,063.66

HW687

DC

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: DC017B Imperial Cleaners (former) SRCR (ERIC_4789)

DATE: 4/27/23

This TA authorizes costs for completion of a Site Rehabilitation Completion Report (SRCR). The total cost of this TA is $2,063.66. This entire cost is fixed unit rate. This TA was negotiated - the total cost is $654.87 or 24% less than originally proposed.

The purpose of this TA is to document site conditions meet RMO I closure requirements. SRCR approval will trigger completion of an SRCO, subsequent well abandonment, and subsequent site closure (entries in ERIC/DEP databases). Site access was confirmed.

FDEP COST ESTIMATE

Contractor: Terracon

Date: 4/26/2023 Task #: HW687 SubTask 1 SRCR SubTask 6

Site: Imperial Cleaners (Former) ERIC_4789 SubTask 2 SubTask 7 Activity/Phase: SRCR SubTask 3 SubTask 8

Project Manager: Dean Cox SubTask 4 SubTask 9 SubTask 5 SubTask 10

Totals 1 2 3 4 5 Labor Rate Category

$64.50 Project Manager Donna Cline 1.23 1.23 $0.00 Administrative 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Brownfield Consultant 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0

$22.25 CADD Specialist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Data Analyst & Visualization Specialist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Environmental Technician 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Field Geologist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Field Scientist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 GIS Technician 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Principal Consultant 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Project Geologist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Project Industrial Hygienist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Project Scientist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0

$64.50 Senior Engineer Donna Cline 2.00 2.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Senior Geologist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Senior GIS Analyst Chelse Fugate 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Senior Industrial Hygienist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Senior Scientist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0

$48.08 Senior Geologist Shawn Ouellette 10.00 10.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 Staff Scientist 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0 $0.00 0.00 0.00 0.00 0.00 0.00 0 0 0 0 0

Total Hours 13.23 1.23 12.00 0.00 0.00 0.00 0 0 0 0 0

Direct Labor $689.07 $79.27 $609.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Overhead 116.00% $799.32 $91.95 $707.37 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Gen & Admin 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fringe 56.26% $387.67 $44.60 $343.07 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Labor $1,876.06 $215.82 $1,660.24 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

REV: 02/03 CEF TERRACON Page 1

FDEP COST ESTIMATEContractor: Terracon Date: 4/26/2023

Task #: HW687 SubTask 1 SRCR SubTask 6 Site: Imperial Cleaners (Former) ERIC_4789 SubTask 2 SubTask 7

Activity/Phase: SRCR SubTask 3 SubTask 8 Project Manager: Dean Cox SubTask 4 SubTask 9

SubTask 5 SubTask 10

Totals 1 2 3 4 5 Travel

Vehicle Rental $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Mileage Costs $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Air Fare $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Per diem + Hotel $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Travel $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor (Equipment Procurement) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Procurement Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor (Services Procurement) Drilling (Conventional) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Drilling (Non-conventional) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Mobile Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Surveying $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

IDW $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Utilities $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Initiation Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Handling Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Laboratory Analytical Costs $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fast Turnaround Charges $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Sample Shipping $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Field Expenses Personal Protection $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Expendables $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Drilling related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Analytical related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (IDW related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Other) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Field Expenses $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subtotal $1,876.06 $215.82 $1,660.24 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Completion Fee $187.60 $21.58 $166.02 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Total Estimated Cost $2,063.66 $237.40 $1,826.26 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

REV: 02/03 CEF TERRACON Page 2

LEVEL OF EFFORT/EXPENSE WORKSHEET

SITE : Imperial Cleaners (Former) ERIC_4789

SUBTASK 2: SRCR

PROPOSAL NO. PH4237157

DATE: 4/26/2023

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Field Task Planning/Initial Site Visit/Month 1 O&M

Senior Geologist SO 6.00 Senior Geologist SO 2.00 Senior Geologist SO Gather TetraTech exhibits 2.00 Senior Engineer DC Prepare Conclusions and Recommendations for SRCR 2.00

CADD CF Prepare base maps 0.00 CADD CF Prepare soil, groundwater assessment exhibits 0.00

Personnel: SO DC CF Hours: 10.00 2.00 0.00 TOTAL LABOR 12.00

Gather summary tables Prepare SRCR Report

5463 West Waters Avenue, Suite 830

Tampa, FL 33584

P (813) 221-0050

F (813) 221-0051

Terracon.com

April 25, 2023

Florida Department of Environmental Protection

Waste Cleanup Program

Waste Management Division

2600 Blair Stone Road

Tallahassee, Florida 32399-2400

Attn: Mr. Dean Cox, Environmental Consultant

E: Dean.Cox@FloridaDep.gov

W: 850-245-8969

M: 727-686-6502

Re: Proposal for Preparation of a Site Rehabilitation Completion Order (SRCO)

Imperial Cleaners (Former)

10055 North Dale Mabry Highway

Tampa, Florida 33618

ERIC_4789

Task Assignment HW687 DC014B

Terracon Proposal No PH4237157

Dear Mr. Cox:

Terracon Consultants, Inc. (Terracon) appreciates the opportunity to submit this proposal to the

Florida Department of Environmental Program (FDEP) Waste Cleanup Program to prepare a Site

Rehabilitation Completion Report (SRCR).

Scope of Services

◼ Prepare an SRCR Report that documents the soil, groundwater, and vapor, assessment activities and confirms that the site meets the No Further Action requirements, without institutional or engineering controls, as defined as a Risk Management Option 1 per Rule 62-780.680 (1), Florida Administrative Code;

◼ Recommend FDEP issue a SRCR for the site;

◼ Submit a SRCR Report, to include site assessment summary tables, exhibits, conclusions, and recommendations.

◼ The SRCR will reference Tetra Tech’s summary tables and drawings. Terracon has no intention of recreating the tables or drawings.

See attached LOE for details

Schedule The SRCR will be submitted within 20 business days of receipt of analytical results.

Compensation See attached CEF for details.

Proposal for SRCR

Imperial Cleaners (Former), ERIC_4789 ■ Tampa, FL

April 25, 2023 ■ Terracon Proposal No. PH4237157

CLOSING REMARKS

Terracon services will be conducted in accordance with the terms and conditions, contained within DEP

Waste Cleanup Program (WCP) Contract No. HW687, executed January 5, 2022. It is understood that a Task Assignment will be issued to authorize us to perform this work.

We appreciate the opportunity to provide this proposal and look forward to working with you on this project. If you should have any questions or comments, please contact either of the undersigned at

813-221-0050.

Sincerely, Terracon Consultants, Inc.

Donna Cline, P.E. Shawn Ouellette, P.G.

Senior Remediation Engineer Senior Geologist

Attachments: Cost Spreadsheet

Level of Effort

Cline, Donna L Stamp