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Okaloosa County BOCC — July 15, 2014 — Judge Ben Gordon Final Pay Request Documents — reading text
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PRODUCTS. CoMPIOP AGG | ¢ Included]
PRO- 3
POLICY SECT Loc
. COMBINED SINGLE LIMIT
») AUTOMOBILE LIABILITY fa accident) $
j |__} ANY AUTO BODILY INJURY (Per person) | +
auios Autos BODILY INJURY (Por accident) | $
| NON-OWNED PROPERTY DAMAGE
HIRED AUTOS NOMS {PER ACCIDENT} $
$
|_| UMBRELLA LIAB occur EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE. AGGREGATE $
oto | Treventions $
WORKERS COMPENSATION WC STATU- OTH:
AND EMPLOYERS’ LIABILITY YIN Tour tins |
ANY PROPRIETOR/PARTNERIEXE CUTIVE E.L. EACH ACCIDENT $
OFFICERMEMBER EXCLUDED? NIA
{Mandatory in NH) ELL. DISEASE - EA EMPLOYEE| $
If yes, dascribe under
DESCRIPTION OF OPERATIONS balow. - EL. DISEASE - POLICY LIMIT | $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
CERTIFICATE HOLDER CANCELLATION
OKALDO1
SHGULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
Okaloosa County Department N ™
¢
|
of Growth Management
45 Attn Abra Grant Specialist AUTHORIZED REPRESENTATIVE
800 Transit Way AJoywe Nodbly—
Fort Walton Beach, FL 32547
© 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
Invoice #1
FDLE Ed Byrne Grant # 2014-JAGC-OKAL-6-E5-082
Units of Service during this period (10/1/2013 to 1/31/2014)
Service |Case name Completed # Units
E $07-512 10 5 $0.00
E $12-744. 44 22 $440.00
E $12-718 39 19.5 $200.00
Vv $12-738 4 4 $65.00
Vv $12-730A 31 31 $110.00
Vv $13-762 8 8 $40.00
Vv $13-763 2 2 $0.00
Vv $10-661A 6 6 $0.00
Vv $13-772 2 2 $50.00
Vv $13-774 6 6 $30.00
Vv $13-775 8 8 $200.00
Vv $13-777 10 10 $250.00
Vv $13-761A 4 4 $100.00
Vv $13-776 5 5 $125.00
Vv $13-779 15 15 $225.00
Vv $13-784 3 3 $45.00
Vv $13-757 2 2 $0.00
199 152.5] $1,880.00
invoice #1
FDLE Ed Byrne Grant # 2014-JAGC-OKAL-6-E5-082
Units of Service during this period (10/1/2013 to 12/31/2013)
# Units Total
Case#/ Date Location of |Type of of Status of Units of
of Service |TimeofService j|Service Service Service |Service Service
807-512
12/24/2013 5:30 PM|Shalimar Exch-R 0.5|Completed
12/24/2013 5:30 PM|Shalimar Exch-R 0.5|Completed
12/14/2013 9:15 AM|Shalimar Exch-P 0.5|Completed
12/15/2013 5:30 PM|Shalimar Exch-R 0.5|Completed
12/19/2013 4:30 PM|Shalimar Exch-P 0.5|Compieted
12/28/2013 12:00 PM|Shalimar Exch-R 0.5}Completed
1/11/2014 9:15 AM|Shalimar Exch-R 0.5]/Completed
1/12/2014 5:30 AM{Shalimar Exch-P 0.5|Completed
1/26/2014 9:15 AM]Shalimar Exch-R 0.5}Completed
1/27/2014 4:30 PM{Shalimar Exch-P 0.5|Completed
$12-744
10/2/2013 4:00 PM)Shalimar Exch-P 0.5|Completed
10/2/2013 4:00 PM|Shalimar Exch-P 0.51Completed
10/2/2013 6:15 PM|Shalimar Exch-R 0.5|Completed
10/4/2013 4:00 PM|Shalimar Exch-P 0.5}Completed
10/6/2013 5:15 PM|Shalimar Exch-R 0.5}Completed
10/9/2013 4:00 PM|Shalimar Exch-P 0.5|Completed
10/9/2013 6:15 PM|Shalimar Exch-R 0.5|Completed
10/16/2013 4:00 PMjShalimar Exch-P 0.5|Completed
10/16/2013 6:15 PM Shalimar Exch-R 0.5|Completed
10/18/2013 4:00 PM]Shalimar Exch-P 0.5|Completed
10/20/2013 5:15 PM|Shalimar Exch-R 0.5|Completed
10/23/2013 4:00 PMjShalimar Exch-P 0.5iCompleted
10/23/2013 6:15 PM|Shalimar Exch-R 0.5|Completed
10/30/2013 4:00 PM|Shalimar Exch-P 0.5|Completed
10/30/2013 6:15 PM]Shalimar Exch-R 0.5}Completed
11/1/2013 4:00 PMjShalimar Exch-P 0.5}Completed
11/3/2013 5:15 PM|Shalimar Exch-R 0.5|Completed
11/6/2013 4:00 PM|Shalimar Exch-P 0.5|Completed
11/6/2013 6:15 PM{Shalimar Exch-R 0.5|Completed
11/13/2013 4:00 PM|Shalimar Exch-P 0.5|Completed
11/15/2013 4:00 PM {Shalimar Exch-P 0.5|Completed
11/17/2013 5:15 PM{Shalimar Exch-R 0.5{Completed
11/20/2013 4:00 PM|Shalimar Exch-P 0.5]|Completed
11/20/2013 6:15 PM|Shalimar Exch-R 0.5}|Completed
11/22/2013 4:00)Shalimar Exch-P 0.5}Completed
12/4/2013 4:00 PMjShalimar Exch-P 0.5|Completed
12/4/2013 6:15 PM]Shalimar Exch-R 0.5|Compieted
12/11/2013 4:00 PMjShalimar Exch-P 0.5|Completed
12/11/2013 6:15 PM|Shalimar Exch-R 0.5|Completed
12/13/2013 4:00 PM|Shalimar Exch-P 0.5|Completed
12/15/2013 5:15 PM|Shalimar Exch-R 0.5|Completed
12/18/2013 4:00 PM}Shalimar Exch-P 0.5}Completed
12/18/2013 6:15 PM|Shalimar Exch-R 0.5|Completed
12/28/2013 12:00 PMjShalimar Exch-P 0.5|Completed
1/5/2014 5:30 PM|Shalimar Exch-R 0.5|Completed
1/8/2014 4:00 PM|Shalimar Exch-P 0.5|Completed
1/8/2014 6:15 PM|Shalimar Exch-R 0.5|Completed
1/15/2014 4:00 PMjShalimar Exch-P 0.5|Completed
1/15/2014 6:15 PM|Shalimar Exch-R 0.5|Completed
1/17/2014 4:00 PM|Shalimar Exch-P 0.5|Completed
1/20/2014 5:15 PM|Shalimar Exch-R 0.5|Completed
1/22/2014 4:00 PM}Shalimar Exch-P 0.5|Completed
1/22/2014 6:15 PM|Shalimar Exch-R 0.5|Completed
1/31/2014 4:00 PM|Shalimar Exch-P 0.5|Completed 22
$12-718
10/2/2013 3:45 PM|Shalimar *Exch-P 0.5|Completed
10/2/2013 6:45 PM|Shalimar *Exch-R 0.5|Completed
10/6/2013 5:30 PM|Shalimar *Exch-P 0.5|Completed
10/13/2013 5:30 PM]Shalimar *Exch-R 0.5|Completed
10/16/2013 3:45 PM|Shalimar *Exch-P 0.5|Completed
10/16/2013 6:45 PMjShalimar *Exch-R 0.5|Completed
10/23/2013 3:45 PM|Shalimar *Exch-P 0.5|Completed
10/23/2013 6:45 PMjShalimar *Exch-R 0.5|Completed
10/30/2013 3:45 PM|Shalimar *Exch-P 0.5|Completed
10/30/2013 6:45 PM|Shalimar *Exch-R 0.5|Completed
11/1/2013 5:30 PM|Shalimar *Exch-P 0.5|Completed
11/3/2013 5:30 PM {Shalimar *Exch-R 0.5}Completed
11/6/2013 3:45 PM|Shatimar *Exch-P 0.5|Completed
11/6/2013 6:45 PM|Shalimar *Exch-R 0.5|Completed
11/13/2013 3:45 PM|Shalimar *Exch-P 0.5|Completed
11/13/2013 6:45 PM|Shalimar *Exch-R 0.5|Completed
11/15/2013 5:30 PM|Shalimar *Exch-P 0.5|Completed
11/17/2013 5:30 PM}Shalimar *Exch-R 0.5|Completed
11/20/2013 3:45 PM|Shalimar *Exch-P 0.5]/Completed
11/20/2013 6:45 PM|Shalimar *Exch-R 0.5]/Completed
12/4/2013 3:45 PM|Shalimar *Exch-P 0.5]/Completed
12/4/2013 7:00 PM|Shalimar *Exch-R 0.5|Completed
12/11/2013 3:45 PMjShalimar *Exch-P 0.5|Completed
12/11/2013 6:45 PM{Shalimar *Exch-R 0.5}Completed
12/13/2013 5:30 PMjShalimar *Exch-P 0.5}Completed
12/15/2013 5:30 PM{Shalimar *Exch-R 0.5}Completed
12/18/2013 3:45 PM{Shalimar *Exch-P 0.5}Completed
12/18/2013 6:45 PM]Shalimar *Exch-R 0.5|Completed
12/28/2013 12:00}Shalimar Exch-P 0.5}Completed
1/8/2014) 3:45 PMjShalimar *Exch-P 0.5|Completed
1/8/2014 6:45 PM{Shalimar *Exch-R 0.5} Completed
1/10/2014 5:30 PM|Shalimar *Exch-P 0.5}Completed
1/12/2014 5:30 PM|Shalimar *Exch-R 0.5;Completed
1/15/2014 3:45 PM|Shalimar *Exch-P 0.5|Completed
1/15/2014 6:45 PMj{Shalimar *Exch-R 0.5}Completed
1/22/2014 3:45 PM|Shalimar *Exch-P 0.51Completed
1/22/2014 6:45 PM|Shalimar *Exch-R 0.5}Completed
1/24/2014 5:30 PM|Shalimar *Exch-P 0.5|Completed
1/26/2014 5:30 AM|Shalimar *Exch-P 0.5}Completed 19.5
$12-738
11/2/2013}9:30 - 11:00 AM _ |Shalimar Visit 1{Completed
11/9/2013]9:30 - 11:00 AM (Shalimar Visit 1/Completed
11/16/2013]9:30 - 11:00 AM |Shalimar Visit 1)Completed
12/14/2013|9:30 - 11:00 AM _ {Shalimar Visit 1|Completed 4
$12-730A
10/1/2013]3:15 - 4:45 PM {Shalimar Visit 1)Completed
10/3/2013}3:15 - 4:45 PM _—_|Shalimar Visit 1}Completed
10/8/2013}3:15 - 4:45 PM_—‘|Shalimar Visit 1|Completed
10/10/2013}3:15 - 4:45 PM _—_‘|Shalimar Visit 1}Completed
10/16/2013|3:15 - 4:45 PM [Shalimar Visit 1|Completed
10/17/201313:15 - 4:45 PM —‘|Shalimar Visit 1}Completed
10/22/2013]3:15 - 4:45 PM _—_|Shalimar Visit 1|Completed
10/24/2013|3:15 - 4:45 PM _—_|Shalimar Visit 1}Completed
10/29/2013]/3:15 - 4:45 PM_—_‘|Shalimar Visit 1}Completed
11/2/2013} 11:30 - 1:00 PM_ {Shalimar Visit 1)Completed
11/5/2013]3:15 - 4:45 PM_—_‘|Shalimar Visit 1{Completed
11/7/2013}3:15 - 4:45 PM ___|Shalimar Visit 1]Completed
11/12/2013}3:15 - 4:45 PM —_|Shalimar Visit 1)Completed
11/14/2013/3:15 - 4:45 PM —_|Shalimar Visit 1jCompleted
11/19/2013|3:15 - 4:45 PM_—_|Shalimar Visit 1|Completed
11/21/2013]3:15 - 4:45 PM —_|Shalimar Visit 1|Completed
11/26/2013|5:00 - 6:30 PM —_|Shalimar Visit 1|Completed
12/3/2013]3:15 - 4:45 PM_—_|Shalimar Visit 1}Completed
12/5/2013}3:15 - 4:45 PM _—_|Shalimar Visit 1|Completed
12/10/2013|3:15 - 4:45 PM _—_ {Shalimar Visit 1,Completed
12/12/2013|3:15 - 4:45 PM —_|Shalimar Visit 1|Completed
12/17/2013}3:15 - 4:45 PM {Shalimar Visit 1)/Completed
12/19/2013|3:15 - 4:45 PM [Shalimar Visit 1/Completed
1/2/2014|5:00 - 6:30 PM {Shalimar Visit 1]Completed
1/7/2014|3:15 ~4:45 PM [Shalimar Visit 1)Completed
1/9/2014}3:15 - 4:45 PM _—_‘ {Shalimar Visit 1/Completed
1/14/2014]3:15 - 4:45 PM {Shalimar Visit 1|Completed
1/16/2014|3:15 - 4:45 PM {Shalimar Visit 1{Completed
1/21/2014]3:15 - 4:45 PM Shalimar Visit 1/Completed
1/23/2014|3:15 - 4:45 PM_—_‘ {Shalimar Visit 1|Completed
1/30/2014]3:15 - 4:45 PM —_|Shalimar Visit 1]Completed 31
$13-762
10/11/2013]3:15 - 4:45 PM —_|Shalimar Visit 1]Completed
10/31/2013]3:15 - 4:45 PM {Shalimar Visit 1/Completed
11/12/2013]5:00- 6:30PM {Shalimar Visit 1)Completed
11/15/2013}3:15 - 4:45 PM {Shalimar Visit 1|Completed
11/26/2013]3:15 - 4:45 PM — [Shalimar Visit 1|Completed
12/13/2013|3:15 - 4:45 PM {Shalimar Visit 1|Completed
12/21/2013}9:30 - 11:00 AM {Shalimar Visit 1}Completed
1/15/201413:15 - 4:45 PM _—_|Shalimar Visit 1]/Completed 8
$13-763
10/5/2013}11:30 - 1:00 PM _ |Shalimar Visit 1|Completed
10/19/2013}11:30 - 1:00 PM |Shalimar Visit 1|Completed 2
$10-661A
10/4/2013)5:00-6:30PM |Shalimar Visit 1/Completed
10/11/2013}5:00 - 6:30 PM = jShalimar Visit 1|Completed
10/25/2013}5:00 - 6:30PM —_|Shalimar Visit 1|Completed
11/1/2013|5:00 - 6:30PM {Shalimar Visit 1/Completed
11/27/2013]5:00 - 6:30 PM {Shalimar Visit 1/Completed
12/13/2013]5:00 - 6:30 PM —_|Shalimar Visit 1|Completed 6
$13-772
10/9/2013]3:15 - 4:45PM {Shalimar Visit 1/Completed
11/1/2013|3:15 - 4:45 PM —_|Shalimar Visit 1)Completed 2
$13-774
10/3/201315:00 - 6:30 PM _—_‘|Shalimar Visit 1]Completed
10/4/2013}3:15 - 4:45 PM {Shalimar Visit 1}Completed
10/9/2013}5:00 - 6:30 PM _—_|Shalimar Visit 1}Completed
10/15/2013]5:00 - 6:30PM {Shalimar Visit 1|Completed
10/24/201315:00 - 6:30 PM {Shalimar Visit 1|Completed
10/31/2013]5:00 - 6:30PM {Shalimar Visit 1}Completed 6
$13-775
10/3/2013}3:15 - 4:45 PM —jShalimar Visit i1}Completed
10/18/2013}3:15 - 4:45 PM_—‘ [Shalimar Visit 1|Completed
10/25/2013/3:15 - 4:45PM {Shalimar Visit 1|Completed
11/2/2013]9:30 - 11:00 AM {Shalimar Visit 1|Completed
11/7/2013|3:15 - 4:45 PM_—_|Shalimar Visit 1|Completed
11/15/2013]3:15 - 4:45 PM —‘|Shalimar Visit i|Completed
1/3/2014|3:15 - 4:45PM [Shalimar Visit 1/Completed
1/10/2014|3:15 - 4:45 PM_—_‘|Shalimar Visit 1|Completed 8
$13-777
10/10/2013]5:00 - 6:30 PM Shalimar Visit 1}Completed
10/23/2013 |5:00 - 6:30 PM Shalimar Visit 1|Completed
11/8/2013 3:15 - 4:45 PM Shalimar Visit 1|Completed
11/12/2013{5:00 - 6:30 PM Shalimar Visit 1|Completed
11/13/2013 [5:00 - 6:30 PM Shalimar Visit 1|Completed
12/3/2013}5:00 - 6:30 PM Shalimar Visit 1|Completed
12/14/2013]11:30 - 1:00 PM Shalimar Visit 1|Completed
12/21/2013]11:30- 1:00PM —_|Shalimar Visit 1|Completed
1/29/2014}11:30 - 1:00 PM Shalimar Visit 1|Completed
1/31/2014] 11:30 - 1:00 PM Shalimar Visit 1|Completed 10
S$13-761A
10/1/2013|1:00 - 2:30 PM — {Shalimar Visit 1|Completed
10/8/2013)|1-2:30 pm Shalimar Visit 1|Completed
10/10/2013}1-2:30 PM Shalimar Visit 1|Completed
10/30/2013|5:00 - 6:30 PM _—_‘ {Shalimar Visit 1|Completed 4
$13-776
10/2/2013|5:00 - 6:30 PM _—_|Shalimar Visit 1|Completed
10/12/2013}11:30 - 1:00 PM _ |Shalimar Visit 1]/Completed
10/19/2013]9:30 - 11:00 AM {Shalimar Visit 1)Completed
11/6/2013]5:00 - 6:30PM —_|Shalimar Visit 1|Completed
11/30/2013]11:30 - 1:00 PM _ |Shalimar Visit 1|Completed 5
$13-779
10/2/2013]5:00- 6:30PM {Shalimar Visit 1/Completed
10/4/2013}3:15 - 4:45 PM_—_‘|Shalimar Visit 1|Completed
410/9/2013]5:00- 6:30PM {Shalimar Visit 1|Completed
10/11/2013]3:15 - 4:45PM _—_|Shalimar Visit 1}Completed
10/16/2013|5:00 - 6:30PM {Shalimar Visit 1|Completed
10/18/201313:15 - 4:45 PM {Shalimar Visit 1|Completed
10/23/2013]5:00- 6:30PM = {Shalimar Visit i|Completed
10/25/2013]3:15 - 4:45 PM