CN-370000-HW687-DC03CCO1.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.

DC003C 1 HW687

Gabriel Sostre 850-245-8749 Terracon Consultants, Inc.

Donna Cline 904-479-7415

ERIC_4650

Vicks Cleaners

$ 16,955.04 $ 16,955.04

$ 16,955.04 $ 16,955.04

03/28/2025 05/02/2025 35

1 1 1

Terracon Consultants, Inc.

Donna Cline

Senior Associate / Remediation Engineer

Jennifer Farrell

Digitally signed by Jennifer Farrell Date: 2024.12.10 08:05:47 -05'00'

N/A

This TACO authorizes a time extension by approximately one month for the deliverables and completion date.

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

Contract Number:

Task Assignment #:

Change Order #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

BWC TAFORM 01/18

FLORIDA DEPARTMENT OF

Environmental Protection

Bob Martinez Center 2600 Blair Stone Road

Tallahassee, FL 32399-2400

Ron DeSantis Governor

Jeanette Nuñez Lt. Governor

Secretary

Memorandum

TO:

FROM:

Negotiation File

ERIC

, Project Manager

SUBJECT: Negotiation Summary Task Assignment (HW687)

DATE: ,

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

DC003C Completion March 28, 2025

Terracon will conduct soil and groundwater sampling and prepare a Supplemental Site

Assessment Report summarizing their activities and results.

Nicole Knutson 850-245-8763 Contractor Terracon Consultants, Inc. Contractor

Contractor Donna Cline Contractor 904-479-7415

ERIC_4650

8645 Pensacola Blvd, Pensacola, Escambia County

Vicks Cleaners

Contractor Contractor

$ 16,955.04

$ 16,955.04

Scope of Work

Terracon Consultants, Inc.

Contractor

Donna Cline

Senior Associate / Remediation Engineer Digitally signed by Cline, Donna L DN: cn=Cline, Donna L, ou=General Users, email=Donna.Cline@terracon.com Date: 2024.09.19 09:22:23 -04'00'

Cline, Donna L

Mubeen Darji

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

Date: 2024.09.19 08:49:23 -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

Subtask 2: Field Notes Deliverable including field notes, boring logs, and groundwater sampling log 12/06/2024

Subtasks 3 & 1: SSAR & PM 01/31/2025

Subtask 2: Upon receipt and FDEP approval of Field Notes Deliverable including field notes, boring logs, and groundwater sampling log $ 12,128.14

Subtasks 3 & 1: Upon receipt and FDEP approval of SSAR & PM $ 4,826.90

$ 16,955.04

HW687

DC003C