CN-370000-LE807-2I-68808.pdf

This is a Work Authorization Form issued by the Florida Department of Environmental Protection, Office of Emergency Response. The document authorizes work to be performed by ACT (contractor) under Contract #LE807, with Ashley Shive serving as the representative. The incident is identified as DEP Incident #2022-2168008, dated 3/18 & 3/21, and is located in West Palm Beach, Palm Beach County, Florida at the JW Corbett site.

The authorized work is classified as a spill response requiring immediate action involving petroleum materials. The level of effort includes one supervisor, two recovery technicians, one driver, and equipment consisting of one response truck, one straight truck, one pickup/van, five 55-gallon drums, and work clothes for PPE. Analytical and disposal arrangements will be managed via the contractor. The work assignment is designated as fixed price with a not-to-exceed estimate amount of $10,000. Funding information indicates Project #LK8007, Organization Code 3704010000, EO FC, Object Code 139001, Fund 049001, and Category/Year 10149.2, with an approved amount of $10,000 as of 5/2/2022. The document was approved by Bridgjette Bucell (DEP Representative), the contractor representative, and the OER Budget Representative on 5/2/2022.