Okaloosa County BOCC — June 2, 2015 — Film Commission final payment

CONTRACT CLOSE-OUT CHECKLIST (To Be Prepared by the Purchasing Services Coordinator) DATE: May 15,2015 TO: Contracts & Grants Manager, Finance Department Contracts & Grants Office SUBJECT: Contract No. C12-1928-T1DC MANAGING DEPARTMENT: TDD CONTRACTOR'S NAME: Gail Morgan PROJECT TITLE: Emerald Coast Film Commission Services The aftached has met the final payment contract requirement in subject contract. Yes I, Final Invoice X 2. Completed Contract/Lease Payment Approval Form X 3. Close-Out Documents Yes No a. Signed Release of Lien J Il b. Proof of Completion Advertisement [ J c. Certificate of Insurance ] ] d. Consent of Surety to Final Payment | ] e. Proof of Performance/Payment Bond [] ] Continuation 12 Months Following Final Payment Yes 4, Agenda Request X 5. Remarks 2\ J-Is-15 No 0 O MXXXX L g Purchasing Services Coordinator DATE CONTRACT/LEASE PAYMENT APPROVAL FORM COMPLETE AND FORWARD TO THE NEXT DEPARTMENT e | COMPLETED BY DEPARTMENT DATE: 05/13/15 VENDOR NAME: GAIL MORGAN VENDOR #: 21200456 CONTRACT/LEASE # C12-1928-TDC VENDOR TASK COUNTY/FEMA BUDGET ACCOUNT # | AMOUNT $ INVOICE# ORDER # PROJECT # DEPARTMENT # (If Applicable) (If Applicable) 5 s 7 See Attached 1151 534003 $408.60 Services from May 1-4, 20157 TOTAL $408.60 APPROVED FOR PROGRESS PAYMENT (Please sign as applicable and date) el CONTRACTOR'S ENGINEER/ARCHITECT/PROJET MANAGER: COUNTY SUPERVISOR/PROJECT MANAGER: DEPARTMENT DIRECTOR: " _CONTRACTS & GRANTS MANAGER: MOWTY ADMINISTRATOR: Payments>8§25,000.) E—- DATE: DATE: DATE: DATE: DATE: FINAL PAYMENT FINAL PAYMENT YES _X NO (If ""Yes", forward to Purchasing Services Coordinator for Close-Out) DATE: 9|(5% PURCHASING DIRECTOR 4(/,4.( W‘M a/é, (Per Initial Agreement) DATE: /Z //¢ /5 CONTRACTS & GRANTS MANAGER (AII Contracts) &/ DATE: COUNTY ADMINISTATOR APPROVAL DATE: (Per Initial Agreement) BOARD APPROVAL (Per Initial Agreement) ——— COMPLETED BY FINANCE - ACCOUNTS PAYABLE ONLY FISCAL YEAR: DATE RECEIVED: REVIEWED BY: Gail Morgan P.O. Box 4921 Santa Rosa Beach Florida 32459 #C12-1928-TDC BILL TO: INVOICE Ed Schroeder Director Tourist Development Department 1540 Miracle Strip Parkway SE Ft. Walton Beach, FI 32548 Invoice Date - May 5, 2015 Check Pay Gail Morgan Tax ID # 261-11-2840 Contract ID # #C12-1928-TDC Project: Film Commission Services DATE # Periods DESCRIPTION RATE AMOUNT May 1-4, 2015 Film Commission ~ $408.60 Sevices for May 1-4, 2015 : Thank you! Sub total: $408.60 Tax rate: Tax: Previous amount owing: Credit: You pay this amount: $408.60