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Okaloosa County BOCC — 2013 meeting #1140 (date undetermined) — DOC061813 — reading text
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CONTRACT/LEASE
PAYMENT APPROVAL FORM
COMPLETE AND FORWARD TO THE NEXT DEPARTMENT
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COMPLETED BY DEPARTMENT
DATE: _ _ . : . :05:. :. :/2=2c.. .: /1=--3
VENDOR NAME: AQUA TIC PLANTS OF FLORIDA, INC VENDOR #: -=-20"-'8-'-00c:. . : 2:. . :.0.:. _9_ __
CONTRACT/LEASE # C13-2020-TDC
VENDOR TASK COUNTY/FEMA BUDGET ACCOUNT# AMOUNT$
INVOICE# ORDER# PROJECT# DEPARTMENT#
(If Applicable) (If Applicable)
23881 116 I lOr I ~ 534900 f!iiQQ,IU fi,ll
Pf. 11011 534qoo ~10~46'6 .05"
TOTAL $200,916.11
APPROVED FOR PROGRESS PAYMENT (Please sign as applicable and date)
CONTRACTOR'S ENGINEER/ARCHITECT/PROJET MANAGER: DATE:
COUNTY SUPERVJSORIPROJE~
CT ~ ~~~~~ DATE: ~13
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DEPARTMENT DIRECTO R:
CONTRACTS & GRANTS MAN R:
DATE:
DATE:
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COUNTY ADMINISTRATOR: DATE:
Payments>$25, 000.)
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FINAL PAYMENT
FI NALPAYMENT YES_x_No_ rdinator for Close-Out)
DATE: Oft>. ((3. ( 3 PURCHASING DIRECTOR
(Per Initial Agreement)
DATE: £4- :l~- \::?:> CONTRACTS & GRANTS MANAGER
(A ll Contracts)
DATE: _ _ __ COUNTY ADMINISTATOR APPROVAL
(Per Initial Agreement)
DATE: BOARD APPROVAL
- - - - (Per Initial Agreement)
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COMPLETED BY FINANCE- ACCOUNTS PAYABLE ONLY
FISCAL YEAR:
DATE RECEIVED:
REVIEWED BY: