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Board of County Commissioners
State of Florida
PUBLIC WORKS DEPARTMENT
Solid Waste Office
1759 S. Ferdon Blvd.
Crestview, FL 32536
December 20, 2013
Ms. Nita Hosfelt
Collection Bureau Medical Accounts Administration
P.O. Box 4127
Fort Walton Beach, FL 32549
Dear Ms. Hosfelt:
Enclosed you will find documentation for two accounts for which Okaloosa County Solid
Waste would like to request collection assistance.
For your convenience, I have listed the account address information below.
Cash Customer Name Contact Number Address Amount
Solid Waste Haulers, LLC (850) 259-5293 4 Laguna Street, #201 $12,185.96
Owners: Todd Schweizer Brenda Will Ft. Walton Beach, FL 32545
Joshua Schweizer
Vince Czarnecki (850) 543-5171 62 Martissa Rd $ 37.85
Pensacola, FL 32503
Please refer all questions regarding the above accounts to Ann Halbert in our Solid Waste
office at (850) 423-4825. IfI can be of further assistance please do not hesitate to call (850)
689-5772, Thank you for your time and efforts.
Sincerely,
John Hofstad,
/\| Public Works Director
Enclosures
JH/ah
1759 S. Ferdon Blvd, Crestview, FL 32536
Office.(850) 689-5774 @ Fax (850) 689-5786
. Medical Accounts © ‘min
Collection Bureau . PO Box 4127
Ft. Walton Beach, FL 32549
PHONE: (850) 862-2154
FAX: (850) 864-1780
_ Client Acknowledgement Report
4/8/2014
Public Works Department
Ann Halbert
1759 S Ferdon Blvd
Solid Waste Office
Crestview, FI. 32536
AccountNo. Name Client Invi: SubmissionDate Amount
2210194 Czarnecki Vince 01/08/2014 $37.85
2210193 Solid Waste Haulers ; 01/08/2014 $12,185.96
Accounts: 2 Amount: $12,223.81
We gratefully acknowledge the attached account listing. These accounts are now being processed by our staff. If you
have any questions, please give us a call.
If because of an error, it becomes necessary to cancel any account, we will process your request as soon as
possible. However, we will not cancel any account that we have received a promise of payment on without our
full commission.
Thank you for allowing us to serve you collections needs.
Collection Bureau
State of Florida
. RECEIVED
Board of County Commissioners JUL 3-1 RECO
wy fil
kat
a. =
Solid Waste Department
Acknowledgement of Balance Due
’ Date: Y/acli2 Weighmaster’s Initials: d i)
Ticket Number: _[ 255 89 Amount Due: A? B53
Amount Paid: po
Balance Due: 37.85:
Name: \); nce CZarneclee
Address: 62 Mardis ‘ ph
Er Welter Beet FL 3548
Phone: SU 3 5S /7/ Cell Phone:
Driver’s License #: C 682 ~Y2L- 2¢- “Rol- O
VEHICLE
License Plate Number: CL tf 7 ro R G- State: Fl
a a Clos
Make: for 2- Model: _/ 7-330 Year. /999
CUSTOMER ACKNOWLEDGEMENT
| acknowledge that payment is owed to Okaloosa County Solid Waste Office for
services rendered.
| also understand that failure to pay by the end of the business day will make this
obligation delinquent and subject to further action. |
Vis Cad Lael
Signature Date
RETURN FORM TO CUSTOMER AFTER PAYMENT RECEIVED ALONG WITH A COPY OF SOLID WASTE TICKET.
$
Balance Due Paid Customer Initials Date
Leave this section blank until payment received.
1759 S, Ferdon Blvd, Crestview, FL 32536
Office (850) 689-5772 © Fax (850) 689-5786
\. (SITE | TICKET te _ ee l “WEIGHMASTER -
oe — WEIGHMASTER
i
' Scott Wolf
i i
WRIGHT LANDFILL 03 | 125589
671 N. BEAL EXTENSION Dare iN woe - a = —-- --]
-ORT WALTON BEACH, FL 32548 [Le PS SI - SEIIEEE MORE SEE
07/26/13 O7/26/13 14:57
{ i 1
100000 CASH CUSTOMER
BLUFORDTRL | Customer Od Mt Pay
Scale 1 Gross Wt. 13340 LB Inbound - Cash ticket
Scale 1 Tare Wt. 11480 LB
_Net Weight 1860 LB
mi!
nm
=
_!
ary ar DESCRIPTION, BATE Jf FE
0.93 TON Yard Waste '40.70 : : 0.00 37.85
1.00 EACH PER LOAD RES FEE i 5.00 : 5,00 ! 0.00 . 5,00
1.00 EACH PER LOAD CREDIT |-5.00 ; 5.00 | 0.00 : -5.00
| |
| |
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Sh = —- wo ee Po a _
Dperating hrs 7AM to 3:30PM Monday - Friday/7AM to 12PM Sat C °
This is to certify that this load does not contain any C Ledbor ga Puck
jazardous materials.
AWall TO REORDER CONTACT CAROLISA SOFTWARE ivitn 700-6767 SIGNATURE _.
Okaloosa County Solid Waste
1759 South Ferdon Bvld.
Crestview, Fl. 32536
(850) 689-5772
SOLID WASTE HAULERS
Brenda Will
4 LAGUNA ST STE 201
FORT WALTON BEACH FL 32548-3627
06/30/14
fezaust rele dt fe 4
Je -oft sch pled
a
Make checks payable to Board of County Commissioners
Balance due by August 20, 2014
Printed 08/01/14
07/31/14
12185.96
Balance Forward
Current charges excluding fees
Current fees
Total balance due
by Lolleet ol A ont
gloat
463
12185.
96
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00
12185.
96
