Okaloosa County BOCC — August 6, 2013 — Emerald Coast CAC Final Payment — reading text

: PROPERTY DAMAGE 5 HIRED AUTOS (Per accident) ; |__| NON-OWNED AUTOS } wen ae Js i |__| UMBRELLA LIAB | OCCUR EACH OCCURRENCE | $s. EXCESS LIAB CLAIMS-MADE AGGREGATE = 8 |__| DEDUCTIBLE hous 8 RETENTION _§ 1 i$ AND EMBL OVERS LABILITY | xT S6e9innes’ “EE B | ANY PROPRIETORPARTNERIEXECUTIVE ; u ztwecaD1670 : 101812 | 10813 © EL. EACH ACCIDENT s 1,000,000 OFFICERIMEMBER EXCLUDED? : . {Mandatory n Ni) — : ELL. DISEASE - EA EMPLOYEE) $ 1,000,000) BESERITION OF OPERATIONS below i "ELL. DISEASE - POLICY LIMIT | $ 1,000,000) A [Employee i IPHPK947582 ? 4273192 | 12/3143 ‘Limit 50,000) Dishonesty ! : | ‘Ded 5,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (attach A ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Okaloosa County BCC 602 C North Pearl Street Crestview, FL 32536 AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD mber ii, 2013 's Advocacy Center, cert invoice is correct and that is dees not duplicate reimbursement of costs or services received from ciner sources. In addition, | certify that reimbursement is requested oniy fer expenditures on tems appr 8 terms and conditions of the agreement with the County.” Az (3 Date April 1 - 30, 2013 EMERALD COAST CHILDREN'S ADVOCACY CENTER MONTHLY INVOICE 1550.41 EDWARD BYRNE MEMORIAL STATE AND LOCAL LAW ENFORCEMENT ASSISTANCE FORMULA GRANT CATEGORIES TOTAL INVOICE EXPENDITURES BUDGET AWARD AMOUNT TO DATE BALANCE Contractual Services Personne! $20,000.00 $1,569.49 $19,244.79 $755.21 TOTAL $ 20,000.00 [$ 7,569.49 [$ 19,244.79 |S 755.21 / 13-Sep-13 JULIE HURST oN DATE TYPED NAME OF AUTHORIZED SIGNATURE april2013inv 9/13/2013 AUTHORED SIGNATURE \ i \ Piease make check payabie to: Emeraid Coast Chiidren’s Advocacy Center, inc. P. O. Box 1237 Niceville, FL 32588 Debbie Hollis Apr-13 4,137.17 +125 {176 *48 Compensation Benefits $4,262.17 $24.22 § $435.96 $435.96 | $33.35 264,25461.80 /176 *18 $326.05 $1.85 § $33.35 Rick Leggett 3,240.01 + 125 i176 *14 $3,335.01 $18.95 | $265.28 i §265.28 | $20.29 206.77 + 48.36 /176 *14 $255.13 $145 | $20.29 Vida Brinson 3554.64+125 /176 *21 $3,579.64 $20.91 — $439.05 f $439.05 {| $33.59 228.14 + 53.35 /176 *24 $281.49 $1 $33.59 Julie Hurst 6,863.76 + 125 /176 *8 $6,988.76 $39.71 @ $317.67 | $307.67 | $24.30 433.304101.34 {176 *8 $534.64 $3.04 | $24.30 Total Per Cost Category! $1,457.95 111.53 Total Cast! $1,568.49 RptBatchSum ViewForm - Page 1 of 1 Synovus Report Date: 04/22/2013 Emerald Coast Childrens Advoca Report Time: 09:45:47 AM Batch Summary Report by 1D Number Company Name: Emerald Coast946 Effective Date: 04/30/2013 ACH ID: 593454168 Batch Sequence: 4 Application Name: Consumer Payments Database Name: MONTH END PAYROLL Batch Status: Released Neme iD Amount D/C BankID Account # Acct Trace # 2D Amount DiC Type SIEGAL, WILLIAM F $2,118.24 C 083100277 005492034126 c CHRISTINA ORES $1,289.12 C 263178070 506211 c CAROZZONI, RENEE CAROZZONI $2,085.07 C 263178070 0004458782 c CROWELL, KATHERINE CROWELL $i85128 C 314074269 196114644 c HOLLIS, DEBORAH J. DJH $3,136.24 C 263178070 ono2zse6032 Cc FLORO, JENNIFER JENNIFER $3,925.47 C 314074269 © 12428547 c HURST, JULIEH. 9 JHH $5,332.25 C 063210112 3277427947 Cc COTTON, LISA Lc $2,331.28 C 263178070 0008003478 c LEWELLYN, SHEILA 1 EWELLYN $1,890.45 C 263178070 000835932 c LEGGETT, RANDALL RANDALL LE RANDALL $2,481.76 C 063208140 463521 c DUNN, THOMAS D. TDD $3716.29 C 063212631 143123 c BRINSON, VIDAL. VLB $2,464.33 C 263178070 802821 c OFFST EMERALD coasTada BATCH OFFSET $32,621.78 /D 063208140 94946 c Tofai Amount in Batch Total Count in Batch Debits $32,621.78 1 Credits $32,621.78 12 Prenotes $0.00 0 Grand Total Amount Grand Total Count Debits $32,621.78 1 Credits $32,621.78 12 Prenotes $0.00 is} https://businessinternetbanking.synovus.com/wempr/rptbatchsumviewform.jsp?source=BA.,. 4/22/2013 4f22/13 at 08:33:35.68 ECCAC, Inc. Payroll Check Register For the Period From Apr 1, 2013 to Apr 30, 2013 Filter Criteria includes: Report order is by Check Date. Report is printed in Detail Format. Page: 1 Reference Date Employee Amount 4/3013 Vida L. Brinson 2,464.33 4730/13 Tom Dunn 3,716.29 4/30/13 Deborah J. Hollis 3,136.24 4130N3 Julie Hurst 5,332.26 4/30/13 Randall R. Leggett 2,481.76 4/30/13 Jennifer ©. Floro 3,925.47 4/30/13 Katherine M. Crowelt 1,861.28 483013 Renee Carozzoni 2,085.07 4/30/13 Sheila D. Lewellyn 1,890.45 4/30/13 Lisa Cotton 2,331.28 4/3013 William F. Siegal 2,118.24 413013 Christina A. Jeffries 1,289.12 4/1/13 thru 4/30/13 32,621.78 4/1/13 thru 4/30/13 32,621.78 A/22I13 at 08:33:41.27 ECCAC, Inc. Payroll Journal For the Period From Apr 1, 2013 to Apr 30, 2013 Filter Criteria includes: Report order is by Check Date. Report is printed in Detail Format. Page: 1 Date GLAcctiD Reference Debit Amt Credit Amt Employee 4/3013 714001 3,554.64 Vida L. Brinson 711001 125.60 330001 298.82 330001 228.14 330001 §3.35 334001 10,00 335001 500.00 758201 125.00 330001 228.14 330001 53.35 773001 228.14 773001 53.35 107001 2,464.33 4/30/13 714001 5,043.81 Tom Dunn 711001 125.00 330001 907.10 330001 320.47 330001 74.95 334007 25.00 768201 125.00 330001 320.47 330001 74.95 773004 320.47 773001 74.95 107001 3,716.29 4/30/13 711001 4,137.17 Deborah J. Hollis 711004 125.00 330001 423.70 330001 264.25 330001 61.80 335001 260.00 768201 126.18 330001 264.25 330001 61.80 773001 264.25 773001 61.80 107001 3,136.24 4/30/13 711001 6,863.76 Julie Hurst 711001 125.00 330001 870.73 330001 433.30 330001 101.34 334001 20.00 335001 100.00 758201 134.14 330001 433.30 330001 101.34 773001 433.30 773001 101.34 107001 5,332.25 4/30/13 711001 3,210.01 Randall R. Leggett 711001 125.00 330001 243.38 330001 206.77 330001 48.36 334004 2.00 335001 200.00 758201 182.74 330001 206.77 4/22/13 at 08:33:41.66 ECCAC, Inc. Payroll Journal For the Period From Apr 1, 2013 to Apr 30, 2013 Filter Criteria includes: Report order is by Check Date. Report is printed in Detail Format. Page: Z Date GLAcctID Reference Debit Amt Credit Amt Employee 330001 48.36 773001 206.77 773001 48.36 407001 2,481.76 413013 711001 4,506.25 Jennifer O. Floro 711001 125,00 330001 123.96 330001 287.14 330001 67.15 335001 100.00 768201 127.63 330001 287.14 330007 67.15 773001 287.14 773001 87.15 107001 3,925.47 4130/13 711001 2,511.96 Katherine M. Crowell 711001 125.00 330001 308.36 330001 163.49 330001 38.24 335001 150.00 758201 125.69 330001 163.49 330001 38.24 333001 3.15 773001 163.49 773001 38.24 773001 3.15 107001 1,851.28 4/30/13 711001 3,093.75 Renee Carozzoni 711004 425.00 330001 403.13 330001 199.56 330001 46.67 335001 100.00 758201 384.32 330001 198.56 330001 46.67 773004 199.56 773001 46.67 107001 2,085.07 4130/13 711001 2,407.08 Sheila D. Lewellyn 711001 125.00 330001 318.12 330001 156.99 330001 36.72 758201 132.80 330001 156.99 330001 36.72 333001 10.20 773001 156.99 773001 36.72 773001 10.20 107001 1,890.45 4/303 711001 3,093.75 Lisa Cotton 711001 125.00 330001 419.58 4/22/13 at 08:33:41.77 ECCAC, Inc. Payroll Journal For the Period From Apr 1, 2013 to Apr 30, 2013 Filter Criteria includes: Report order is by Check Date. Report is printed in Detail Format. Page: 3 Date GL Acct 1D Reference Debit Amt Credit Amt Employee 330001 199.56 330001 46.87 758201 221.66 330001 199.66 330001 46.67 773001 199.56 773001 46.67 107001 2,331.28 4/30/13 711001 2,875.00 William F. Siegal 711007 125.00 330001 497.26 330001 186.00 330001 43.50 758201 155.00 330001 186.00 330001 . 43.50 773001 186.00 773001 43.50 107001 2,118.24 413013 711001 1,845.42 Christina A. Jeffries 711001 110.06 330001 406.71 330001 121.24 330001 28.35 758201 110.06 330001 121.24 330001 28.35 333007 19.95 773001 121.24 773001 28.35 773001 19.96 407001 1,289.12 48,074.97 48,074.97 Welcome To EFTPS - Payments Page 1 of 1 Elgctronie Feder! Tax Payment Syste HOME ENROLLMENT MY PROFILE PAYMENTS HELP & INFORMATION CONTACT US: LOGOUT TAXPAYER NAME: EMERALD COAST CHILDRENS ADVOCACY TIN: xxxxx4168 Deposit Confirmation Your payment has been accepted. Payment Successful An EFT Acknowledgement Number has been provided for this payment. Please keep this number for your records. REMINDER: REMEMBER TO FILE ALL RETURNS WHEN DUE! EFT ACKNOWLEDGEMENT NUMEER: 270351483584894 PLEASE NOTE Any amounts represented in the subcategories of Social Security, Medicare, and Income Tax Withholding are for ini rmational purposes only. Payment Information Entered Data Taxpayer EIN XXKKX4168 Tax Form 941 Employers Federal Tax Tax Type Federal Tax Deposit Tax Period Q2/2013 Payment Amount $12,045.87 Settlement Date 04/24/2013 * Subcategories: 1 Social Security $5,533.82 2 Medicare $1,294.20 3 Tax Withholding $5,217.85 Home Enreliment My Profile Payments Help & Information Contact Us Logout USA.gov IRS.gov Freasury.gov Electronic Federal Tax Payment System® and EFTPS® are registered servicemarks of the U.S. Department of the Treasury's Financial Management Service. https://www.eftps.gov/eftps/payments/payment-confirmation-flow?execution=e2s] 4/22/2013 Statement of Account i Coastal Bank and Trust ‘A DIVISION OF SYNGVUS BANK, MEMBER FDIC Last statement: March 31, 2013 PO BOX 12956 PENSACOLA. FL 32591-2965 This statement: April 30, 2013 Total days in statement period: 30 000-009-494-6 031 «560 Page 1 of 3 PAPA eeac rere iene calc eriecerrverry ii EMERALD COAST CHILDRENS ADVOCACY CENTER Direct inquiries to: FPO BOX 1237 888 825-6954 NICEVILLE FL 32588-1237 Beginning balance 247,046.25 Deposits/Credits 158,973.48 Low balance 259,247.53 Withdrawals/Debits 88,792.41 Average balance 314,272.39 Ending balance 317,227.32 Average collected balance 316,196.00 Checks |Number Date Amount | {Number Date Amount | 7809 04-18 460.00 8034 04-17 248.29 7810 04-22 275.75 8035 04-12 §,694.46 8008 * 04-04 700.00 8036 04-11 190.00 8009 04-02 2,126.03 8037 04-16 980.00 8011 * 04-02 558.00 8038 04-18 90.50 8013 * 04-03 6,770.37 8039 04-15 15.00 8014 04-15 1,400.00 8040 04-16 244,53 8015 04-10 4,288.50 8043 * 04-25 2,928.30 8016 04-03 390.06 8044 04-25 354.94 8017 04-08 188.15 8045 04-30 254.77 8018 04-08 47.17 8047 * 04-29 926.75 8019 04-04 959.35 80438 04-29 1,782.00 8020 04-05 65.05 3049 04-29 120.00 8022 * 04-71 638.52 8052 * 04-29 257.81 8023 04-03 23.85 8053 04-29 437.79 8025 * 04-19 250.00 8055 * 04-29 1,002.87 8027 * 04-15 111.99 8056 04-30 128.71 8028 04-15 $19.99 8057 04-29 3,219.66 8029 04-15 92.40 8058 04-29 248.63 8030 04-29 139.92 8059 04-26 200.00 8031 04-16 250.86 8060 04-25 101.34 8632 04-15 204.10 8061 04-24 193.50 8033 04-19 14.49 * Skip in check sequence § Coastal Bank and Trust A DIVISION OF SYNOVUS BANK, MEMBER FDIC April 30, 2013 000-009-494-5 PO BOX 12966 PENSACOLA. FL 32591-2956 Page 2 of 3 EMERALD COAST CHILDRENS ADVO Other Debits | Date Transaction Type Description Amount | 04-02 Preauthorized Wd Bkcd Processing Bkcd M Dsc ¢ 392.74 130402 273800043450 04-04 Preauthorized Wd Square Inc 13040302 a 0.46 130404 M155242636 04-04 Preauthorized Wd Merche-Solutions Billing 166.23 130404 000000010177032 ol fers 04-10 Preauthorized Wd City Of NICEV136 Debits 209.10 130410 010-02640-01 04-15 Preauthorized Wd City Of Defuniak Utility Pd 214,94 130415 18350 04-19 Preauthorized Wd Okaloosa Gas 211 Debits 71.20 130419 002007870086374 04-22 ~—- Preauthorized Wd Gulf Gulf EFT 1,273.25 130422 2703490002NCV 04-23 Preauthorized Wd Rbms Premium Be Bill 318.00 130423 3306707 04-24 = Preauthorized Wd IRS Usataxpymt 12,045.87 130424 270351483584891 04-25 Preauthorized Wd Verizon Wireless Payments 444.24 130425 051348562500001 04-30 = Preauthorized Wd Fla Dept Revenue Cut 940.20 130430 000000002113179 04-30 Preauthorized Wd Emerald COAST9456 Credits 32,621.78 a 130430 BATCH OFFSET