CN-550000-C9V55-00050000.pdf

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

TASK WORK ORDER AMENDMENT FORM

FOR PROFESSIONAL SERVICES

375-030-26

PROCUREMENT

06/17 recovered is $ .

79,569.60 .

Subtotal Check if

Estimate

$0.00

$26,201.16

$0.00

$165,103.80

$0.00

$0.00

$191,304.96

$0.00

$191,304.96

Attachments:

Distribution:

Quality Counts, LLC

Atkins North America, Inc.

$21,195.19

$165,103.80

($79,569.60)

$0.00

($79,569.60)

Departmental Approval:

Total authorizations to date (including this one):

Other Notes:

An independent assessment of the staff hours and quantities for the proposed services has been performed, and found to be fair, reasonable, and competitive.

Page 1 subtotal

Page 2 thru 6 Subtotal

Total 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

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

The total amount for services performed under this task work order is increased by $

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.

elements are described below.

from this task work order $ . Note: for Prof. Serv. Task Work Order Amendments, the encumbrance line should never be closed

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

(Status 50) by Financial Services staff based on this selection.

The subject task work order is hereby canceled (no work has been performed and no payment is due). The total amount of the task work order which is

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

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

(LS2) Lump sum paid based on % of completion

(LA4) Units worked at loaded billing rates in

Table 6

(LS2) Lump sum paid based on % of completion

($21,195.19)

Compensation Element

Description

This Amendment

Amount

Cambridge Systematics, Inc.

($49,075.15)

Eland Engineering, Inc.

($9,299.26)

Previous

Amount

$49,075.15

$35,500.42

Method of Compensation

(LS2) Lump sum paid based on % of completion

(Title)

Steven McWilliams

Signature

Vice President

(Name)

$419,768.46

(Name) (Title) Signature

Jonathan Ford Project Manager

Professional Services, Financial Services, Atkins North America, Inc., File

Consultant Acceptance:

Payment FM No. (must be the same as original Task Work Order):

22976573201

Check all applicable Terms:

To realloacte funds to a new task work order that will define a new scope of work. (This new scope of work will occur under task work order 4 of this contract).

2001 NW 107th Avenue Doral, FL 33172

Atkins North America, Inc.

Address:

Consultant:

Date (To be entered upon execution of Task Work Order Amendment):Contract No.:

C9V55

Purpose of Amendment:

Amendment No.

to Task Work Order No.

DocuSign Envelope ID: 6F64ACAD-CAAA-47CD-9537-15A8C3EBF7D2

3/13/2018 | 1:15 PM EDT