Okaloosa County BOCC — March 1, 2016 — essi final

CONTRACT CLOSE-OUT CHECKLIST (To Be Prepared by the Purchasing Services Coordinator) DATE: February 17, 2016 10: Confracts & Grants Manager, Finance Department Contracis & Granis Office SUBJECT: Contract No. C09-1752-FM MANAGING DEPARTMENT: Facility Maintenance CONTRACTOR'S NAME: Emergency System Services PROJECT TITLE: Generator Maintenance The attached has met the final payment coniract requirement in subject contract. Yes No 1. Final Invoice X O 2 Completed Contract/Lease Payment Approval Form X 3 Close-Out Documents Yes No N/A a. Signed Release of Lien O O X b. Proof of Completion Advertisement OJ Ul X c. Certificate of Insurance ] ] X d. Consent of Surety to Final Payment ] ] X e. Proof of Performance/Payment Bond | ] = Continuation 12 Months Following Final Payment < = o es X O 4, Agenda Request 5 Remarks 217V Purchasing Services Coaeifrdtor DATE CONTRACT/LEASE PAYMENT APPROVAL FORM COMPLETE AND FORWARD TO THE NEXT DEPARTMENT = COMPLETED BY DEPARTMENT paTE: 02/23/2016 VENDOR NAME: Emergency Systems Services, InC vENDOR #: 015440 CONTRACT/LEASE#: C09-1752-FM TASK COUNTY/FEMA VENDOR BUDGET INVOICE # ORDER # PROJECT # DEPARTMENT #| ACCOUNT# AMOUNT"$ (If Applicable) (If Applicable) 214618 0112 546620 $192.49 214362 0112 546620 $175.01 TOTAL $ 367.50 APPROVED FOR PROGRESS PAYMENT (please sign. as applicable and date) CONTRACTOR'S ENGINEER/ARCHITECT/PROJECT MANAGER: / N DATE: COUNTY SUPERVISOR/PROJECT MANAGER: Jarf)?S\DUko » f,,UU_Zp/ DEPARTMENT DIRECTOR: Jason Autrey Y, : , & : - contracts & araNT MANAGER: (131, Enti Ko Wil B. Eulboks d COUNTY ADMINISTRATOR: DATE: (Payments=>$25,000.) [: =1 FINAL PAYMENT FINAL PAYMENT YESNOD (If "Yes", forward to Purchasing Services Coordinator for Close-Out) DATE: 2/23//6 PURCHASING DIRECTOR: ¢ / (Per Initial Agreement) 3 \ DATE: /rl/ 24 [l CONTRACTS & GRANTS MANAGER: B, Eubrinbs A (All Contracts) DATE: Mé COUNTY ADMINISTRATOR APPROVAL: ! F (Per Initial Agreement) DATE: _____ BOARD APPROVAL: (Per Initial Agreeine:t) 4 COMPLETED BY FINANCE - ACCOUNTS PAYABLE ONLY FISCAL YEAR: DATE RECEIVED: REVIEWD BY: EMERGENCY SYSTEMS SERVICES, INC. P.O.BOX 1178 LILLIAN, AL 36549 PHONE: 251-961-7104 24 HOUR EMAIL: essibd@gulftel.com Bill To OKALOOSA CO. FACILITY MAINTENANCE 5489 OLD BETHEL ROAD CRESTVIEW, F1. 32336 ATTN: ACCOUNTS PAYABLE Invoice Date Invoice # 10/5/2015 214362 SITE SERVICE PERFORMED Performed Site Inspection Scheduled Maintenance on Genset. Tested and topped off all fluids. Load tested the battery. Checked timit shutdowns. Tested ATS. Generator Model and Specs P.0. No, Terms Site GENERAC 2047626 C09-1752-¥M NET 30 DAYS FLEET OPS NORTH ftem Description ‘ Oty Rate Amount SITE: FLEET OPS NORTH [LABOR SERVICE |SCHEDULED CONTRACT SERVICE AMOUNT i 175.01 175.01 FINAL PAYMENT Subtotal $175.01 Sales Tax (0.00) $0.00 1yau would like to receive email "specials”, please provide us with your email address! Total $175.01 Balance Due $175.01 EMERGENCY SYSTEMS SERVICES, INC. P.O.BOX 1178 LILLIAN, AL 36549 PHONE: 251-961-7104 24 HOUR EMAIL: essibd@gulftel.com Bill To invoice Date Invoice # 12/30/2015 214618 OKALOOSA CO. FACILITY MAINTENANCEE 5489 OLD BETHEL ROAD CRESTVIEW, FL 32536 ATTN: ACCOUNTS PAYABLE SITE SERVICE PERFORMED Performed Site Inspection Scheduled Maintenance on Genset. ‘Tested and topped ofT all fluids. Load tested the battery. Checked limit shutdowns. Did not test ATS. Generator Model and Specs P.0. No. Terms Site GENERAC 4487780 NET 30 DAYS INFO 8YS/HEADS IN tem Description Qty Rate Amount SITE: INFQ SYS/HEADS IN LABOR SERVICE {SCHEDULED CONTRACT SERVICE AMOUNT 1 192.49 192,49 Subtotal $192.49 Sales Tax (0.00) $0.00 you would like to reccive cmail "specials”™, please provide us with your emiail addresst TOtal $192.49 Balance Due $192,49 The following are the requirements for the annual preventive maintepance and repair for the generators referenced above: 1) Siatic checks a) Air Intake System. b) Check or replace air filter as n