CN-370000-WQ177-T1.pdf

OOO-019 (Effective Page 1 of 2

Florida Department of Environmental Protection

TASK ASSIGNMENT FORM

Required Signatures: Adobe Signature

FDEP Contract No: Task Assignment No: Date:

Project:

Contractor Name:

Contractor Representative: Phone: Email:

Phone: Email:

Task Description:

Deliverables:

Performance Measures:

Financial Consequences:

DEP Task Manager:

FDEP Contract Manager:

WQ177 1 Tracy Woods 2024 Dam Owner Workshop

Association of State Dam Safety Officials (ASDSO)

Jennifer Burns 859-550-2788 JBurns@damsafety.org

Tracy Woods 850-245-7530 Tracy.Woods@FloridaDEP.org

ASDSO will provide the 2024 Florida Dam Safety Program Dam Owner Workshop, The Need-To-Know-Basics of Owning a Dam, on May 7, 2024, in a virtual format by a qualified instructor, per the attached scope of services.

Task 1: 1) ASDSO will provide a coordination meeting summary, attendee log, final agenda, training recording, and presentation(s) to FDEP and 2) Certificates of Completion / Professional Development Hours to attendees.

Deliverables will be reviewed by FDEP to confirm they are complete, accurate, and timely.

As per Professional Services Contract No. WQ177 between FDEP and ASDSO.

OOO-019 (Effective Page 2 of 2

Florida Department of Environmental Protection

TASK ASSIGNMENT FORM

Schedule:

Start Date: Completion Date:

Fixed Price Cost: Cost Reimbursement not to exceed:

Total Task Value:

Signatures and Date:

1._________________________________ __________________________________ __________________ Manager, Signature Date

2._________________________________ __________________________________ __________________ Manager, FDEP Signature Date

3. _________________________________ __________________________________ __________________ , FDEP Signature Date

Encumbrance Information:

Budget Entity

Project

Grant

Org Code Category & Year

Fund Special Category

Object Code

EO Amount

Total:

4. _________________________________ __________________________________ __________________ Program Administrator Signature Date

Upon execution of this TA June 6, 2024

$10,000 $10,000

Jennifer Burns, ASDSO Jennifer Burns Digitally signed by Jennifer Burns Date: 2023.11.09 14:28:28 -05'00' 11/9/2023

Tracy Woods Tracy Woods Digitally signed by Tracy Woods Date: 2023.11.09 14:33:39 -05'00'

Avery Lehmann Digitally signed by Avery Lehmann Date: 2023.11.16 15:41:28 -05'00'

Borja Crane-Amores

37350400 DAM24 37355050000 100628 261019 100628 132800 LG 10,000.00

Borja Crane-Amores Digitally signed by Borja Crane- Amores Date: 2023.11.17 12:08:20 -05'00'