HomeMy WebLinkAboutContract Status Change - ChecklistSTATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
CONTRACT STATUS- CHANGE/CHECKLIST
Info Provider: Michelle Loren Meaux
Return to: Michelle Loren Meaux
Mail Station: Room 6202E
Phone # of Info Provider: 305-470-5112
CONTRACT NUMBER: AP726
Total Executed Contract Amount: $ 100,000.00
COMPTROLLER
01/08
STATE COMPTROLLER USE:
Received date:
Approved date:
Approved by:
SITE/DISTRICT: 6
I $ 100,000.00
To date This action
Status Code (choose one) Z 10= Executed Contract • ❑ 4X or6X,=Audit Status (Indicate Year)
❑ 20 = In Claims ❑ 99 = Post Design Service ❑ 50 = Complete/Terminated Contract
® Original Contract ❑ Amendment (Indicate #)
❑ Award ❑ Supplemental (Indicate #)
❑ Time Extension 0 Close Contract
❑ Renewal ❑ Addition (Indicate #)
❑ Letter of Authorization (Indicate #)
❑ Other Changes (must include comments)
LETTING DATE: AWARD DATE:
DATE OF CONTRACT EXECUTION (Last Signed Date):
If last date signed > contract start date you must submit emergency certification (287.059 F.S. (2) 1) or
Certificate of noncompliance (287.059 F.S. (2)) or settlement document (CM4(87-88) or CM11 (91-92)).
CONTRACT BEGINNING DATE: 6/26/2008 ENDING DATE: 6/30/2009
SERVICES BEGINNING DATE: SERVICES ENDING DATE:
VENDOR NAME: City of Miami VENDOR NUMBER (FEID/SS): F596000375128
PROJECT NUMBER: 249640-3-58-01 PROJECT NUMBER:
PROJECT NUMBER: PROJECT NUMBER:
CAN THIS CONTRACT BE RENEWED? 0 YES ® NO SERVICE TYPE:
PAGE NUMBER RENEWAL CLAUSE IN CONTRACT:
Comments:
Contract executed; Update to Status 10
SR 933/NW 12m Avenue Bridge from NW 14th St. to NW 20th St.
Certification Statement: I certify that the above information is correct and a true reflection of information contained in the above
referenced contract.
Approved by: (Printed or typed) Title:
Approval Signature: Approval Date: