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

“Ve7390318. £900.00 HOLLI9,DEBORAH : 87 300 328 KK 7980 $260.00 67200988 $260.00 FLOROWJENNIFER OWOZARSKL MRS ‘87313 748 YOK AK 5472 $100.00 gzain7z4a 100.00 LEGGETT RANDALL RMR 87 313 963 0001001518 $200.00 672.519.969. g200.00 QAROZZONIRENEE EMRG 87317 O17 . OOK XX 2300 $100.00 - 87317017 ____ 4100.00 OROWELL.KATHERINE M 87 317 027 HKK XX 3666 . $100.00 szawzoor __sseeap” 7 So ,00 HURST JULIE HMS 0 87317 132 HOCK 8474 $100.00 azai7132 __ 100.00. OOTTON, LISA RMRS. Q 87 924 661 , XKK XX 4873 | $100.00 * New premium ae of tls bill. ** Bled amount has been reduced to prevent violation of current taxlawe, We wil not bill this polloy again until we can acoept further payment, Group Number: 05733 Group Name: EMERALD COAST CHILDRENS ADVOCACY Reason Codes for Adjustments; - (1) permanently remove policy from billing (2} permanently change premium amount Variable Products are offered through property licensed registered representatives. (Page 1 Sf 2) ; ORIGINAL DOCUMENT PEINTED ON CHEMICAL REACTIVE PAPER WITH MICROPHINTED BORDER G68 ORDER New York Life Insurance . * VOID CHECKS OVER $1500.00 REQUIRE TWO SIGNATURES bio ee AGTHORIZED SIGNATURE 75 Remittance Dr., Suite 3021 Chicago, IL 60675-3021 q wee as ee ee pee eee =: 1 i & aan a _ | COASTAL BANK AND TRUST i a~s EMERALD COAST CHILDREN'S ADVOCACY CENTER, INC. ae See ae . ony "coast RO. SOX 1237 3 Childrens _— NICEVILLE, FL 92588-1237 ; a ; i — - ; “pe “AMOUNT A | ; Apr 30, 2013 | “*$ 1,400.00 3 | pay One Thousand Four Hundred and 00/100 Dollars 5 | . : . i | AFTER 90 DAYS é } TOTHE 3 i i } wOOaOkaK OG 3 208 140009 Lok Er (Page 2 of 2) auaH asuouna (3 CR TO ACCT OF PAYEE ABSNCE OF ENDRS GTD. NORTHERN TRUST >071000152< 130507 93021-4215-8 Agency Name: Emerald Coast Children's Advocacy Center, Inc. Employee Name: Rick Leggett Title: Mental Health Therapist MONTHLY TIMESHEET Project Name: Mental Health program Pay Period: April 1 - April 30, 2013 Department: Supervisor: Julie Hurst Exempt Non-Exempt Hours per| % per ganas Funding Funding 16117 | 18) 19 | 20 | 21 | 22) 23 26 TOTAL| Source or | Source or Grant Project Grant Grant Project Project 7.00 | 7.00 | 7.00 8.00 136.00 GR 1.00 | 4.00 | 8.00 8.00 | 8.00 26.00 162.00 92.05% 0.00 1.00 14.00 Byrne 0.00 14.00 7.95% 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0 0.00 Total Number of 8.00| 8.00] 8.00/ 8.00/ 0.00/ 0.00] 8.00] 8.00 8.00 176.00] 176.00 | 10.00% Hours by Date By signing below, 1 Gearby attest Employee's Signature; Supervisor's signatite-— Ss soe 4 {DD Date: CL ~) | Agency Name: Emerald Coast Children's Advocacy Center, Inc. Employee Name: Debbie Hollis Title: Clinical Supervisor MONTHLY TIMESHEET Project Name: Mental Health program Pay Period: April 1 - April 30, 2013 Department: Supervisor: Julie Hurst Exempt Non-Exempt [7] . Hours per| % per funding Funding | Funding Grant PayType| 1/ 2/3 ,],4/5]6/] 7] 8 | 9 | 10] 11] 12] 13) 14} 15] 16] 17] 18] 19) 20) 21| 22) 23) 24 | 25} 26) 27 | 28 | 29 | 30} 31 | TOTAL! Source or | Source or Project Grant Grant Project Project REG 7.00 } 8.00 | 7.00 | 8.00 | 6.00 7.00 | 8.00 | 8.00 | 8.00 | 8.00 5.00 | 8.00 | 7.00 {| 6.00 | 7.00 7.00 | 6.00 | 8.00 | 7.00] 8.00 6.00 | 8.00 158.00 GR [PTO 0.00 158.00 89.77% HOLIDAY “0.00 REG 1.00 1,00 2.00 1.00 3.00 4.00 | 2.00| 1.00 1.00 | 2.00 4.00 2.00 18.00 Byrne j|PTO 0.00 18.00 10.23% HOLIDAY 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0 0.00 Total Number of ° Hours by Date 8.00/ 8.00} 8.00] 8.00] 8.00] 0.00] 0.00] 8.00] 8.00) 8.00) 8.00) 8.00| 0.00] 0.00 8.00} 8.00] 8.00/ 8.00] 8.00 0.00) 0.00} 8.00] 8.00] 8.00] 8.00] 8.00] 0.00) 0.00) 8.00] 8.00} 0.00] 176.00] 176.00 100.00% By signing below, | hearby attest that the time recorded on this timesheet is true and accurate to the best of my knowledge. a Employee's Signature: 0, Date: Supervisor's Signature: Cy | cw ) Date: 4B \ID dL) Bt S | MONTHLY TIMESHEET Agency Name: Emerald Coast Children's Advocacy Center, Inc. Employee Name: Julie Hurst Project Name: Mental Health program Title: CEO Pay Period: April 1 - Aprii 30, 2013 Department: Supervisor: Julie Hurst Exempt Non-Exempt [] . Hours per] % per source or Funding | Funding Grant Pay Type] 1] 2/3] 4|546)| 71] 8 | 91410] 4141] 12) 13} 14] 18) 16] 17 | 18) 19 | 20) 21 | 22 | 23) 24) 25) 26 | 27 | 28 | 29 | 30 | 31 | TOTAL; Source or | Source or Project Grant Grant 2 Project Project REG 8.00 | 8.00 | 8.00 { 8.00 | 8.00 8.00 | 8.00 | 8.00 | 8.00 | 8.00 8.00 | 8.00 | 8.00 | 8.00 | 8.00 8.00 | 6.00 | 6.00] 6.00 | 6.00 8.00 | 8.00 168.00 GR {PTO 0.00 168.00 95.45% HOLIDAY 0.00 REG 2.00 | 2.00 | 2.00 | 2.00 8.00 Byrne {PTO 0.00 8.00 4.55% HOLIDAY 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 9 0.00 ‘Hours by Date 8.00} 8.00) 8.00} 8.00} 8.00 of oq 8.00] 8.00] 8.00] 8.00] 8.00} 0.00] 0.00] 8.00) 8.00] 8.00] 8.00] 8.00} 0.00) 0.00] 8.00] 8.00} 8.00] 8.00/ 8.00/ 0.00) 0.00) 8.00) 8.00] 0.00) 176.00} 176.00 | 100.00% By signing below, | hearby attest that the time recorded on this\timesheet is true and accurate to the best of my knowledge. has Date: 4 }2 Date: Employee's Signa Supervisor's Signatuke: Agency Name: Emeraid Coast Children's Advocacy Center, Inc. Employee Name: Vida Brinson Title: Mental Health Therapist MONTHLY TIMESHEET Project Name: Mental Heaith program Pay Period: April 1 - April 30, 2013 Department: Supervisor: Julie Hurst Exempt Non-Exempt [] Hours per| % per eoncing Funding | Funding Grant PayTypel 1} 213/]4/65]6/]7)8 1] 9 110] 11] 12] 13] 14) 15) 16} 17) 18119] 20) 21) 22) 23 | 24| 25 | 26 | 27) 28 | 29 | 30 | 31 | TOTAL! Source or | Source or Project Grant Grant Project_| Project REG 8.00 | 7.00 | 7.00 | 7.00 | 8.00 6.00 | 7.00 | 7.00 | 8.00 | 8.00 8.00 | 7.00 | 6.00 | 7.00 | 8.00 7.00 | 6.00 | 7.00 | 6.00 | 8.00 6.00 | 6.00 155.00 GR [PTO 0.00 155.00 88.07% HOLIDAY 0.00 REG 1.00 | 1.00 | 1.00 | 0.00 2.00 | 1.00 | 4.00 } 0.00 | 0.00 0.00 | 1,00 | 2.00 | 1.00 | 0.00 1.00 | 2.00 1.00 | 2.00 2.00 | 2,00 21.00 Byrne |PTO 0.00 21.00 11.93% HOLIDAY 0.00 0.00 0,00 0.00 0.00% 0.00 0.00 0.00 0.00 0.00% 0.00 0.00 0.00 0.00 0 0.00 Total Number of 9, Hours by Date 8.00] 8.00} 8.00] 8.00] 8.00) 0.00] 0.00] 8.00] 8.00} 8.00] 8.00) 8.00] 0.00] 0.00] 8.00} 8.00] 8.00] 8.00} 8.00/ 0.00] 0.00] 8.00} 8.00! 8.00} 8.00] 8.00; 0.00! 0.00} 8.00) 8.00) 0.00; 176.00] 176.00 100.00% By signing below, | hearby attest that the time recorded on this timesheet is true and accurate to the best of my knowledge. a Employee's Signature: Supervisor's Signatu bat: ‘atays 4/39) 15 Date: nw Y/ % ae May 1 - 31,2013 EMERALD COAST CHILDREN'S ADVOCACY CENTER MONTHLY INVOICE 785.68 EDWARD BYRNE MEMORIAL STATE AND LOCAL LAW ENFORCEMENT ASSISTANCE FORMULA GRANT CATEGORIES TOTAL INVOICE EXPENDITURES BUDGET AWARD AMOUNT TO DATE BALANCE Contractual Services-Personnel $20,000.00 $785.68 $20,000.00 $0.00 TOTAL $ 20,600.00 | $ 785.68 1 $ 20,060.00 - zesepts SULIE HURST Shel OS DATE TYPED NAME OF AUTHORIZED SIGNATURE may2013invamended 9/23/2013 Thies SIGNATURE \ Piease make check payabie te: Emeraid Coast Children’s Advocacy Center, inc. P.O. Box 1237 Niceviiie, F L 32588 May-13 Debbie Hollis 4,137.47 +125 /176 *14 $4,262.17 $24.22 § $339.04 1 264.25+61.80 {176 *14 $326.05 $1.85 $25.94 Rick Leggett 3,210.01 +125 {176 3 $3,335.01 $18.95 $56.85 206.77 + 48.36 /176 Cc $255.13 $1.45 $4.35 4 Vida Brinson 3554.644125 1/476 *17 $3,579.64 $20.91 9 $355.42 228.144 53,35 /176 *47 $281.49 $1.60 $37.49 Julie Hurst 6,863.76 +125 {176 fy $6,988.76 $39.71 $6.06 221.72 + 51.85 {176 ° $273.57 Si.55 $0.00 Compensation Benefits i $339.04 | $25.94 T s56.85 | $4.35 [$355.42 | «$27.18 i $0.00 | $0.00 $751.33 $57.48 $808.78 **only requesting remaining grant bala alance $785.68 ——e , RptBatchSumViewForm Page 1 of 1 Synovus Report Date: 05/23/2013 Emerald Coast Childrens Advoca Report Time: 12:10:39 PM Batch Summary Report by ID Number Company Name: Emerald Coast946 Effective Date: 05/31/2013 ACH ID: 593454168 Batch Sequence: 1 Application Name: Consumer Payments Database Name: MONTH END PAYROLL Batch Status: Released Acct Name ID Amount DG BankiD Account # rT Trace # SIEGAL, WILLIAM F $2,118.24 C 063100277 005492034126 Cc CHRISTINA JEFFRIES $1,289.12 C 263178070 506211 c CAROZZONI, RENEE CAROZZONI $2,085.07 C 263178070 0004456782 c CROWELL, KATHERINE CROWELL $1,851.28 C 314074269 136114644 Cc HOLLIS, DEBORAH J. DJH $3,136.24 C 263178070 0002886032 Cc FLORO, JENNIFER JENNIE $3,925.47 314074269 12428547 c HURST, JUUE H. JHH $5,332.25 C 063210112 3277427947 c COTTON, LISA Lc $2,331.28 C 263178070 9005003478 Cc LEWELLYN, SHEILA EWELLYN $1,787.97 C 263178070 000535932 c LEGGETT, RANDALL RANDALL R LEGGETT $2,481.76 C 063208140 463521 c DUNN, THOMAS D. TDD $3,716.29 G 063212631 143123 Cc BRINSON, VIDA L. VLB $2,464.33 © 263178070 802821 c OFFST EMERALD COASTO46 BATCH OFFSET $32,519.30. /D 063208140 94946 Cc Total Amount in Batch Total Count in Batch Debits $32,519.30 1 Credits $32,519.30 12 Prenotes $0.00 9 Grand Total Amount Grand Total Count Debits $32,519.30 1 Credits $32,519.30 12 Prenotes $0.00 0 https://businessinternetbanking .synovus.com/wempr/rptbatchsumviewform jsp?source=BA... 5/23/2013 6/4/13 at 08:53:57.80 ECCAC, Inc. Payroll Check Register For the Period From May 1, 2013 to May 31, 2013 Filter Criteria includes: Report order is by Check Date. Report is printed in Detail Format. Page: 1 Reference Date Employee Amount 5/3113 Arianna G. Roper 237.69 DDO1 5/31/13 Vida L. Brinson 2,464.33 DDO2 5313 Tom Dunn 3,716.29 DDoS 5/31/13 Deborah J. Hollis 3,136.24 DbD04 S313 Julie Hurst §,332.25 DDOS 5/31/13 Randall R. Leggett 2,481.76 DDOS 5/31/13 Jennifer O. Floro 3,925.47 DDO? 5313 Katherine M. Crowell 1,851.28 bBbos BR1N3 Renee Carozzoni 2,085.07 DDOg SIBU13 Sheila D. Lewellyn 1,787.97 DD10 5313 Lisa Cotton 2,331.28 DD11 8/31/13 William F. Siegal 2,118.24 0D12 5313 Christina A. Jeffries 1,289.12 8/1/13 thru 5/31/13 32,756.99 5/1/13 thru 5/31/13 32,756.99 ” G/4/43 at 08:53:52.25 For the Period From May 1, 2013 to May 31, 2013 ECCAG, Inc. Payroll Journal 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 5/3113 7771001 288.00 Arianna G. Roper 330001 28.27 330001 17.86 330001 4.18 330001 17.86 330001 4.18 333001 2.94 773001 17.88 773001 4.18 773001 2.94 107001 237,69 513113 711001 DDO 3,554.64 Vida L. Brinson 711001 125.00 330001 298.82 330001 228.14 330001 53.35 334001 10.00 335001 500.00 758201 125.00 330001 228.14 330004 53.35 773001 228.14 773001 53.35 107001 2,464.33 5/3113 711001 DDe2 §,043.81 Tom Dunn 711001 125.00 330001 907.10 330001 320.47 330001 74.95 334001 25.00 758201 125,00 330001 320.47 330001 74,95 773001 320.47 773001 74.95 407001 3,716.29 5IS1N3 711001 DDOS 4,137.17 Deborah J. Hollis 711001 425.00 330001 423.70 330001 264.26 330001 61.80 335001 250.00 758201 126.18 330001 264.25 330001 61.80 773001 264.25 773001 61.80 107601 3,136.24 5/31/13 711001 DD04 6,863.76 Julie Hurst 711001 125.00 330001 870.73 330001 433.30 330001 401.34 334001 20.00 335001 400.00 758201 131.14 330001 433.30 330001 101.34 773001 433.30 614/13 at 08:53:52.66 Page: 2 ECCAC, Inc. Payroll Journal For the Period From May 1, 2013 to May 31, 2013 Filter Criteria includes: Report order is by Check Date. Report is printed in Detail Format. Date GL Acct 1D Reference Debit Amt Credit Amt Employee 773001 101.34 107001 5,332.26 v 531/13 711001 DD05 3,210.01 Randall R. Leggett 717001 125.00 330001 243.38 330001 206.77 330001 48.36 334001 2.00 335001 200.00 758201 182.74 330001 206.77 330001 48.36 773001 206.77 773001 48.36 407001 2481.76 / 5/31/13 711001 pbos 4,506.25 Jennifer 0. Fioro 711001 125.00 330001 123.96 330001 287.14 330001 67.15 335001 400.00 758201 127.53 330001 287.14 330001 67.15 773001 287.14 773001 67.15 107001 3,925.47 5/31/13 711001 DDO? 2,511.96 Katherine M.