Okaloosa County BOCC — November 1, 2016 — Anderson payment approval

CONTRACT/LEASE @ SCANNED PAYMENT APPROVAL FORM GeD COMPLETE AND FORWARD TO THE NEXT DEPARTMENT COMPLETED BY DEPARTMENT DATE: 10/12/2016 VENDOR NAME: Anderson Columbia VENDOR #: 13216 CONTRACT/LEASE#: C14-2091-PW TASK COUNTY/FEMA VENDOR BUDGET INVOICE # ORDER # PROJECT # DEPARTMENT # | ACCOUNT# SMOHNES (If Applicable) (If Applicable) 71462 3202 553010 2,539.25 Total 2,539.25 APPROVED FOR PROGRESS PAYMENT (please sign, as applicable and date) CONTRACTOR'S ENGINEER/ARCHITECT/PROJECT MANAGER: DATE: COUNTY SUPERVISOR/PROJECT MANAGER: . %/,.——— DATE: 78/ 7//¢ p ryan Moore e DEPARTMENT DIRECTOR: DATE: to ( (I CONTRACTS & GRANT MANAGER: ‘ DATE: COUNTY ADMINISTRATOR: DATE: (Payments>$25,000.) FINAL PAYMENT FINAL PAYMENT YE&K NO ___ (If "Yes", forward to Purchasing Services Coordinator for Close-Out) DATE: )Cl 20 / i PURCHASING DIRECTOR: <~ A ( %y(fiid( (Per Initial Agreement) )6\ pate: /70 /75 /é CONTRACTS & GRANTS MAA\<G>ER: (All Contracts) DATE: /4 2/44// = COUNTY ADMINISTRATOR APPROVAL: @ & L (Per Initial Agreement) / DATE: BOARD APPROVAL: / (Per Initial Agreement) COMPLETED BY FINANCE - ACCOUNTS PAYABLE ONLY FISCAL YEAR: DATE RECEIVED: REVIEWD BY: