Okaloosa County BOCC — March 3, 2015 — Contract Close-Out Checklist, Final Invoice and Certificate of Insurance- RS&H Inc

CONTRACT CLOSE-OUT CHECKLIST (To Be Prepared by the Purchasing Services Coordinator) DATE: 2/10/15 TO: Contracts & Grants Manager, Finance Department Contracts & Grants Office SUBJECT: Contract No. C09-1737-AP MANAGING DEPARTMENT: Okaloosa County Airports CONTRACTOR'S NAME: RS&H PROJECT TITLE: Final Payment The aftached has met the final payment contract requirement in subject contract. Yes No 1. Final Invoice H 2. Completed Confract/Lease Payment Approval Form IZ[/ L] 3. Close-Out Documents Yes No N/A a. Signed Release of Lien ] L] %? b. Proof of Completion Advertisement ] ] c. Certificate of Insurance [Z]/ L] Ol d. Consent of Surety to Final Payment ] ] [Q/ e. Proof of Performance/Payment Bond ] Ol E/ Continuation 12 Months Following Final Payment =< o @ = o 0 4. Agenda Request 5. Remarks R L B DATE P@ Services Eoordinator CONTRACT/LEASE PAYMENT APPROVAL FORM COMPLETE AND FORWARD TO THE NEXT DEPARTMENT = || DATE: 2/23/2015 COMPLETED BY DEPARTMENT VENDOR NAME: RS&H VENDOR #: 20300540 CONTRACT/LEASE# C09-1737-AP Destin ATCT TASK COUNTY/FEMA VENDOR BUDGET INVOICE # ORDER # PROJECT# |pppaprvENT#| ACCOUNT# ARIOURES (If Applicable) (If Applicable) 2010940009-6 Final 13 741418 562490 5.156.10 2010940009-6 Final 13 741422 562490 45832 2010940009-6 Final 13 741422 562490 114.58 TOTAL | $ 5.729.00 APPROVED FOR PROGRESS PAYMENT (please sign, as applicable and date) CONTRACTOR'S ENGINEER/ARCHITECT/PROJECT MANAGER: COUNTY SUPERVISOR/PROJECT MANAGER, y/4 7% DEPARTMENT DIRECTOR: R/ // CONTRACTS & GRANT MANAGER/ 7Y Tra’cy' Sfage, AAE. " Tracy Stage, AAL. COUNTY ADMINISTRATOR: (Payments>$25,000.) Sunil Harman, A.A.E., IAP DATE: 2-23 /S DATE: 2-23- & DATE: z%/gs DATE: DATE: > FINAL PAYMENT YES _Ao 2/z4|s ‘ 1] DATE: PATE: o7 2D pel DATE: %f /5” FINAL PAYMENT PURCHASING DIRECTOR: (Per Initial Agreement) CONTRACTS & GRANTS MANAGER: (All Contracts) COUNTY ADMINISTRATOR APPROVAL: (Per Initial Agreement) __ (f"Yes", forward to Purchasing Services Coordinator for Close-Out) %/M///;// /M / @ . 14 DATE: BOARD APPROVAL: (Per Initial Agreement) [ ] | | COMPLETED BY FINANCE - ACCOUNTS PAYABLE ONLY FISCAL YEAR: DATE RECEIVED: REVIEWED BY Rsm 10748 Deerwood Park Boulevard S O 904-256-2500 Jacksonville, Florida 32256 F 904-256-2501 rsandh.com February 3, 2015 Mr. Tracy Stage, AAE Deputy Director Okaloosa County Airports 1701 State Road 85 N. Eglin AFB, Florida 32542 (850) 651-7160 x 1055 RE: Okaloosa County Airport System Destin Airport - Air Traffic Control Tower Permitting, Design and Bidding Services Contract No. CO9-1737-AP RS&H Project No. 201-0940-009 Task Order No. 13; Invoice 2010940009-6 (Final) Dear Mr. Stage, Enclosed is RS&H Invoice 2010940009-6 for the Destin Airport ATCT Permitting, Design and Bidding Services project. During the past period RS&H submitted the legal description for the wetland mitigation conservation easement. RS&H also maintained communication with the USACOE and NWFWD related to permit requests for encumbrance sketch and title commitment insurance. Please call me at (904) 256-2192 if you have any questions regarding this submittal. Sincerely, \N/Q“{fi : 2 Brad Went\:g Project Manager Enclosure cC: RS&H - File, Accounting RS&H, Inc FL Cert. Nos. AAC001886+1826000956-LCC000210 RSSH Tracy Stage Northwest Florida Regional Airport 1701 State Road 85 North Eglin AFB, FL 32542 1498 Project 2010940009 Contract No. C09-1737-AP Task Work Order No. 013 Lump Sum $424,203.00 Destin ATCT Design Professional Services through January 30, 2015 A.1 Schematic Design A.2 Design Development A.3 Construction Documents A.4 Bidding B.1 Air Traffic Control Tower Specialist B.2 Permitting Svcs-Site & Utilities B.3 Permitting Svcs-Wetland Mitigation Total Fee Billings to Date Fee Totals RS&H, Inc. P.O. Box 4850 Jacksonville, Florida 32201 904-256-2500/Fax 904-256-2520 Tax ID #59-2986466 January 30, 2015 Invoice No: 2010940009 - 6 Project Manager Bradley