Okaloosa County BOCC — November 1, 2016 — EXHIBIT B Pay Approval form

EXHIBIT B CONTRACT/LEASE PAYMENT APPROVAL FORM COMPLETE AND FORWARD TO THE NEXT DEPARTMENT COMPLETED BY DEPARTMENT DATE: VENDOR NAME: VENDOR #: CONTRACT/LEASE#: VENDOR TASK COUNTY/FEMA BUDGET ORDER # PROJECT # ACCOUNT # AMOUNT $ INVOICE # DEPARTMENT # (If Applicable) (If Applicable) TOTAL $ - APPROVED FOR PROGRESS PAYMENT (please sign, as applicable and date) CONTRACTOR'S ENGINEER/ARCHITECT/PROJECT MANAGER: DATE: COUNTY SUPERVISOR/PROJECT MANAGER: DATE: DEPARTMENT DIRECTOR: DATE: CONTRACTS & GRANT MANAGER: DATE: COUNTY ADMINISTRATOR: DATE: (Payments>$25,000.) FINAL PAYMENT FINAL PAYMENT YES NO (If "Yes", forward to Purchasing Services Coordinator for Close-Out) DATE: PURCHASING DIRECTOR: (Per Initial Agreement) DATE: CONTRACTS & GRANTS MANAGER: (All Contracts) DATE: COUNTY ADMINISTRATOR APPROVAL: (Per Initial Agreement) DATE: BOARD APPROVAL: (Per Initial Agreement) COMPLETED BY FINANCE - ACCOUNTS PAYABLE ONLY FISCAL YEAR: DATE RECEIVED: REVIEWED BY: