CN-370000-HW689-DC12BCO3.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.

DC012B 3 HW689

This Change Order extends the TA Completion Date to allow for DEP review/comments/approval of deliverables and Aptim to complete invoicing.

Aaron Cohen 850-245-8974 Contractor Contractor

Contractor Contractor

Contractor

Aptim Environmental & Infrastructure, LLC (APTIM) Eric Kramer 407-287-3216

ERIC_4134

60-Minute Cleaners

✔ $ 100,465.41 $ 100,465.41

$ 100,465.41 $ 100,465.41 Completion

Completion✔ 12/29/2023 06/07/2024 161

Eric Kramer

Eric Kramer Digitally signed by Eric Kramer Date: 2023.12.22 09:32:36 -05'00'

Teresa Booeshaghi

Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2023.12.21 15:16:22 -05'00'

12/21/2023

N/A

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

DC012B

HW689

$ 100,465.41

Field work documentation including sampling logs, site photos, calibration and well logs for MAGS event (Subtask 2)

Field work documentation including sampling logs, site photos, calibration and well logs for soil and groundwater sampling event (Subtask 3)

Email confirmation of completion of Final Well Installation (Subtask 4), Site Assessment Report (Subtask 5) and Project Management (Subtask 1)

Approval of Field work documentation including sampling logs, site photos, calibration and well logs for MAGS event (Subtask 2)

Approval of Email confirmation of completion of Final Well Installation (Subtask 4), Site Assessment Report (Subtask 5) and Project Management (Subtask 1)

Approval of Field work documentation including sampling logs, site photos, calibration and well logs for soil and groundwater sampling event (Subtask 3)

01/27/2023

05/31/2023

07/07/2023

$ 43,743.26

$ 25,713.28

$ 31,008.87

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.

DC012B 2 HW689

This Change Order authorizes a time extension of 90 days to allow for DEP review/comments/approval of deliverables and Aptim to complete invoicing.

Aaron Cohen 850-245-8974 Aptim Environmental & Infrastructure, LLC (APTIM)

Eric Kramer 407-287-3216

ERIC_4134

60-Minute Cleaners

$ 0.00 $ 0.00

$ 0.00 $ 0.00

09/30/2023 12/29/2023 90

1 1 2

Eric Kramer

Eric Kramer Digitally signed by Eric Kramer Date: 2023.09.28 13:21:57 -04'00'

Teresa Booeshaghi

Teresa Booeshaghi Digitally signed by Teresa Booeshaghi Date: 2023.09.28 10:13:41 -04'00'

9/28/2023

N/A

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

Contract Number:

Task Assignment #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST