CN-550000-C8Q69-00020000.pdf

Consultant:

HNTB

Address :

300 Primera Blvd .

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

TASK WORK ORDER AMENDMENT FORM

FOR PROFESSIONAL SERVICES

375-030-26

PROCUREMENT

02/05

Contract Number: (To be entered upon execution of Task Work Order Amendment)

Date: llb1 j".)}) \'2:> C-8Q69

Amendment No. 002 to Task Work Order No. 044 Payment FtJI No' (must be the same as original Task Work Order):

243811 -1-12-06

Purpose of Amendment:

Adjust the completion date for the Task Work Order to match the new contract end of services date.

Check all applicable terms:

D The time for completion of services for the subject task work order is extended thru

181 The subject task work order is hereby closed . Final payment for the task work order has been paid . No additional services or charges are authorized against this task work order beyond the date of execution of this amendment. The following amount is the remaining work order balance to be recovered from this task work order $ _4'-,0_4_0_.8_4 ___ _

D The subject task work order is hereby canceled (no work has been performed and no payment is due).

181 The total amount for services performed under this task work order is increased by$ _4_,0_4_0_._8_4 ___ _

The additional funds will be allocated to the following compensation elements described below.

D The total amount for services performed under this task work order is decreased by $ -------- The decrease in funds will be allocated to the following compensation elements described below.

D There is no increase/decrease in the task work order amount, funds are only redistributed between compensation elements. Revised compensation elements are described below.

Compensation Element Method of Previous This Amendment Subtotal Check if

Description Compensation Amount Consultant Fees (LA3) Hours worked at defined salary rates in Table SB, loaded with rates in $14,643.84 h"able SA

Page 1 subtotals

Page 2 through S subtotals

D Other Notes:

Attachments:

Total Contract Authorizations to Date Including this Amendment $ 1,986,594.64

Departmental Approval:

Brian M. Stanger DS Environmental Engineer

(name) (title)

Consultant Acceptance: ? ~ ~ l:ois Olaz, 'P.E. Va®k ~Ii.,~

(name) '

Distribution: MS 4-S22F (1) , MS 4-S24 (1)

Amount Estimate

$-4,040.84 $10,603.00 D

$0.00 D

$0.00 D

$0.0C D

$0.00 D

$0.0C D $-4,040.84 $10,603.0C

This Amendment T.W.O.

Total Total

$-4,040.84 $10,603 .00

HNTB(1)