Okaloosa County BOCC — May 19, 2015 — MoultonTitleInvoice

OKALOOSA COUNTY CLERK OF THE CIRCUIT COURT M e m o **x*p| EASE RETURN YELLOW FORM WITH RESUBMITTED CONTRACT**** To: PW S 0‘30\\ From: Jodi K Gates, Financial Services Manager \P\S Date: 3/30/2015 : R P R Notificati Re: Return Payment Request Notification Approved to Pay REFERENCE MATERIAL: - The County's Policy and Procedure Manual and forms are available http://www.co.okaloosa.fl.us/Purchasing Documents.html - All contracts/leases can be viewed at http://www?2.co.okaloosa.fl.us/contracts/defaultpage.aspx - FDOT - http://fdotewpl.dot.state.fl.us/CityToCityMileage/viewer.aspx - Section 112.061 Florida Statutes CONTRACT/DIRECT PAY/PO's THE FOLLOWING PAYMENT REQUEST IS BEING RETURNED DUE TO ONE OR MORE OF THE FOLLOWING REASONS Vendor 'Moulton Land Title Inc Invoice Number Title Search Invoice Date 3/16/2015 Purchase Order # Amount $150.00 TRAVEL REIMBURSEMENTS THE TRAVEL SETTLEMENT PAYMENT REQUEST LISTED BELOW IS BEING ADJUSTED AND/OR RETURNED IF FURTHER ACTION IS NEEDED DUE TO ONE OR MORE OF THE FOLLOWING REASONS: Traveler Travel End Date Destination Purpose REASON FOR RETURN: 1st Reason Other - Incorrect payment method Explanation of Return Attached payment request does not qualify as a 'Direct Pay' 2nd Reason Explanation of Return | Pen M T\% Ao ung¥ C\—CQGI‘}‘) CC **¥XNOTE: CORRECTIONS RESULTING IN ANY CHANGE MADE TO A CONTRACT PAYMENT FORM OR SUPPORTING DOCUMENTATION WILL NEED TO BE RESUBMITTED THROUGH THE NORMAL APPROVAL PROCESS™**** Please review, make necessary corrections and resubmit for payment. If you have any questions, contact Olivia Tanner at x3414, Deborah Estelle at x3416 or Jodi Gates at x3413. Thank you. PAYMENT APPROVAL FORM NON-CONTRACT/DIRECT INVOICE PAYMENTS DATE: March 24, 2014 ..... TO: Finance Department-Accounts Payable & 2 Clerk of Circuit Court s =) FROM: Kathy Carroll, Administrative Manager = SUBJECT: Payment Approval J Vendor Name: Moulton Land Title, Inc. Invoice Number: Invoice Date: March 16, 2015 Invoice Amount: $150.00 Budget Account Number: 1001-531900 Project Title: Bobby G. Kennedy Jr. Title Search, Search File # S15-007 INITIALS Date Approved Authorized Personnel: Department Director: V’k/ 3/50 IS 3‘8@941‘ Autrey Vo Remarks: Send to: Moulton Land Title, Inc. 660-A North Ferdon Blvd. Crestview, Fl. 32536 100l - 531400 INVOICE Date: March 16, 2015 FROM: Moulton Land Title, INC.. 660-A North Ferdon Blvd. Crestview, FL 32536 Phone: (850) 689-3180 Fax: (850) 689-3440 TO: Attention: Jeff Henderson Public Works Right of Way Agent 1759 South Ferdon Blvd Crestview, Fl 32536 Search File Number: S$15-007 Name(s)/Owner(s) Searched: Bobby G Kennedy Jr Property Description: Section 22, Township 3 North, Range 23 West, Okaloosa County, Florida Type of Search: Commitment Form Searchsssis P $150.00 L1717 o DU — .$150.00 The above amount is due and payable no later than 30 days from the date hereof. Payment should be made to Moulton Land Title, Inc., and please reference the Search File Number. Should you require anything further, please do not hesitate to call. Thank you, Stacy Williams TITLE SEARCH REPORT (ABSTRACT) Prepared By: Westcor Land Title Insurance Company Prepared for: Moulton Land Title, Inc. Agent ID #: FL1028 Plant Order #: 15-11154 Agent File #:515-007 Reinsurance #: The subject property of this Abstract is specifically described in Search Request Form as provided by Agent. Search Start Date Base thru February 27, 2015 @08:00 AM THE ATTACHED ABSTRACT IS PREPARED FOR THE USE OF AGENT LISTED ABOVE, A POLICY ISSUING AGENT OF WESTCOR LAND TITLE INSURANCE COMPANY, HEREIN 'AGENT', AND [S TO BE USED ONLY FOR AGENT'S EXAMINATION AND DETERMINATION OF THE INSURABILITY OF TITLE TO THE PROPERTY DESCRIBED HEREIN IN CONJUNCTION WITH THE [SSUANCE OF WESTCOR LAND TITLE INSURANCE COMPANY COMMITMENTS, POLICIES AND ENDORSEMENTS. USE OF THE ATTACHED ABSTRACT FOR ANY OTHER PURPOSE IS NOT AUTHORIZED. THE ATTACHED ABSTRACT MAY NOT BE RELIED UPON BY ANY OTHER PARTY NOR