CN-370000-PL352-T10CO1.pdf

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Master Agreement FL|PL352|98085a807314a03bf0b52b5cf8d23d3f
Contract number
PL352
Issued by
Florida

About this file

This is a Task Assignment Change Order Form (OOO-012) issued by the Florida Department of Environmental Protection (FDEP) for contractor F4 TECH on November 28, 2016. The change order, designated as Change Order No. 10-1 under Task Assignment Number 10, was approved and executed by relevant FDEP personnel including Contract Manager Jim Singleton and authorized representatives Johnson_TT and Clark_G.

The change order requests an increase in funding of $21,949 to enable F4 TECH to complete two UMP (Unified Management Plan) Public Process events: one for Myakka River State Park at $40,989 and one for Savannas Preserve State Park at $30,464, for a combined total of $71,453. The original task amount of $49,504 proved insufficient, necessitating the additional funding request. The task completion deadline remains June 30, 2017, with no extension to the task period. The funding is allocated from Org. Code 3710-1000-000 under Special Category 080811 for fiscal year 2016, with all appropriate approvals obtained by November 30, 2016.

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Text version

OOO-012 (Effective 09-14-2015) Page 1 of 2

Florida Department of Environmental Protection

TASK ASSIGNMENT CHANGE ORDER FORM

Required Signatures: Adobe Signature

Task Assignment Number: __________________ Date: _______________ Change Order No.______________

Contractor Name: _________________________________________________________________

Contractor Representative: __________________________________________________________

DEP Contract Manager:

Description of Change (Use additional sheets if necessary):

Change in Task Amount

Item Cost Reimbursement Fee Schedule Total Original Task Amount:

Task amount prior to this change order:

Net increase/decrease in task amount:

Task amount with all change orders:

Change in Task Time

Original task completion date:

Completion date prior to this change:

Net increase/decrease in task period:

Completion date with all change orders:

10 11/28/2016 10-1

F4 TECH

Mark Milligan 850-309-3940

Jim Singleton 850-245-3085

Request increase in funding to have F4 TECH complete two UMP Public Process events for 1) Myakka River State Park ($40,989) and 2) Savannas Preserve State Park ($30,464) for a total of $71,453. Currently, only $49,504 is allocated to this task assignment and an additional $21,949 is needed to complete both UMP Public Process events.

N/A $49,504.00 $49,504.00

N/A $49,504.00 $49,504.00

N/A $21,949.00 $21,949.00

N/A $71,453.00 $71,453.00

June 30, 2017 June 30, 2017 None June 30, 2017

OOO-012 (Effective 09-14-2015) Page 2 of 2

Florida Department of Environmental Protection

TASK ASSIGNMENT CHANGE ORDER FORM

Change in Funding Information

Org. Code E.O. Object Code Budget Entity

Special Category

Grant # Year Amount

CONTRACTOR FLORIDA DEPARTMENT OF

ENVIRONMENTAL PROTECTION

Contract Manager Date Contract Manager Date

APPROVED:

Budget Representative Date

Contractual Authority Date cc: Procurement Section (MS93) Bureau of Finance & Accounting (MS78) - 2 copies

3710-1000-000 QH 139900 37100400 080811 2016 $ 71,453.00

Mark Milligan Digitally signed by Mark Milligan Date: 2016.11.29 11:54:55 -05'00' 11/29/2016 Jim Singleton Digitally signed by Jim Singleton

Date: 2016.11.29 15:24:45 -05'00' 11/29/2016

Johnson_TT Digitally signed by Johnson_TT Date: 2016.11.30 13:54:08 -05'00'

11/30/2016

Clark_G Digitally signed by Clark_G Date: 2016.12.05 15:12:42 -05'00'

12/05/2016

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