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09-08-14P12:03 RCVD
CONTRACT CLOSE-OUT CHECKLIST
(To Be Prepared by the Purchasing Services Coordinator)
DATE: 09/08/2014
TO: Contracts & Grants Manager, Finance Department Contracts & Grants Office
SUBJECT: Contract No. C99-0257-PS
MANAGING DEPARTMENT: Public Safety
CONTRACTOR'S NAME: lntermedix/Advanced Data Processing, Inc.
PROJECT TITLE: Ambulance Billing
The attached has met the final payment contract requirement in subject contract.
Yes No
l. Final Invoice ~ D
2. Completed Contract/Lease Payment Approval Form ~ D
3. Close-Out Documents Yes No N/A
a. Signed Release of Lien D D ~
b. Proof of Completion Advertisement D D ~
c. Certificate of Insurance D D ~
d. Consent of Surety to Final Payment D D ~
e. Proof of Performance/Payment Bond D D ~
Continuation 12 Months Following
Final Payment
Yes No
4. Agenda Request ~ D·
5. Remarks
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