CN-550000-CA374-00110000.pdf
PDF 94 KB Posted
- Contract number
- H9063
- Issued by
- Florida
About this file
The document is a Multiple Task Work Order Closeout Form for Professional Services issued by the State of Florida Department of Transportation (FDOT). It involves Elipsis Engineering & Consulting, LLC, located in Winter Garden, Florida, under Contract No. CA374. The form is dated March 31, 2023, and serves to close out two specific Task Work Orders (TWO 04 and 06).
The document details the closeout of two task work orders with their respective amendment numbers, payment FM numbers, and descriptions. Task Work Order 4 (Amendment 3) is for "Maintenance, Miscellaneous" with a remaining work order balance of $34,611.17, while Task Work Order 6 (Amendment 1) is for "T5686; US 17/92, N of LMB to N of Airport Rd" with a remaining balance of $6,653.03. The total authorizations to date for these task work orders amount to $3,569,122.45. The form certifies that final payments have been made and no additional services or charges are authorized beyond the execution date of this agreement.
View the file
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
MULTIPLE TASK WORK ORDER CLOSEOUT FORM
FOR PROFESSIONAL SERVICES
375-030-99
PROCUREMENT
07/19
Consultant:
Elipsis Engineering & Consulting, LLC Address:
530 South Main Street, Winter Garden, Florida 34787 Contract No.: Date: (To be entered upon execution of Task Work Order Amendment):
CA374
Purpose of Amendment Close out TWO 04 and 06
The task work orders shown in the table below are hereby closed. Final payment for the task work orders have been paid. No additional services or charges are authorized against these task work orders beyond the date of execution of this agreement. Note: for Prof. Serv. Task Work Order Amendments, the encumbrance line should never be closed (Status 50) by Financial Services staff based on this agreement.
TWO No.
TWO
Amendment No.
Payment FM No. Description
The Following Amount is the Remaining Work Order Balance To Be
Recovered
4 3 435504-1-72-10 Maintenance, Miscellaneous $ 34,611.17
6 1 436679-2-62-01 T5686; US 17/92, N of LMB to N of Airport Rd $ 6,653.03
Total Authorizations to date (including this one): $ 3,569,122.45
Departmental Approval:
Tammie Andrews FDOT Project Manager
(name) (title) (signature)
By signing this, I certify that no additional billings will occur against these work orders.
Consultant Acceptance:
Carlos G. Dawson, PE CEI Consultant Engineer
(name) (title) (signature)
Distribution:
DocuSign Envelope ID: E34206B8-BFC4-4E44-BBBB-89E089393CC3
03/31/2023 | 8:52 AM EDT
File details come from the government source that posted it. Updated .