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Okaloosa County BOCC — December 31, 2012 — Meridian Contract Close out form — reading text
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EXHIBIT H
CONTRACT CLOSE-OUT CHECKLIST
(To Be Prepared by the Contracts & Leases Coordinator)
DATE: /29/20)2
TO: Contracts & Grants Manager, Finance Department Contracts & Grants Division
SUBJECT: Contract No. Cll- (3¢4-Gwm |
MANAGING DEPARTMENT: Gvowns Mand cement
CONTRACTOR'S NAME: Meridian Gommumtby Semus Grov?
PROJECT TITLE: $= CDBG Program Administrafiw: Services
The attached has met the final payment contract requirement in subject contract.
Yes No
1. Final Invoice MY OC
2. Completed Contract/Lease Payment Approval Form M ia
3. Close-Out Documents Yes No N/A
a. Signed Release of Lien C] C] fy
d. Proof of Completion Advertisement L] LJ Ad
c. Certificate of Insurance im Contract x LC]
d. Consent of Surety to Final Payment L] CL] hx
e. Proof of Performance/Payment Bond C) CJ Xf
Continuation 12 Months Following
Final Payment
Yes No
4. Agenda Request x C
5. Remarks
BE Jee W/23hye-
ntraet$ and Lease Coordinator DATE