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EXHIBIT H
CONTRACT CLOSE-OUT CHECKLIST
(To Be Prepared by the Contracts & Leases Coordinator)
‘pare: (oti3
TO: Contracts & Grants Manager, Finance Department Contracts & Grants Division
SUBJECT: Contract No. COF- L408 ACA O
MANAGING DEPARTMENT: _/-W/ _ BUS. SEAR
CONTRACTOR'S NAME: Skansti-/lord Assoc.
prosecttimie: (py Shue d Ha sida Gate
The attached has met the final payment contract requirement in subject contract.
<
8
4
°
1. Final Invoice
2 Completed Contract/Lease Payment Approval Form
ac
Close-Out Documents Yes N/A
a. Signed Release of Lien of Oo O
b. Proof of Completion Advertisement ep C] C)
c. Certificate of Insurance up CO cE]
d. Consent of Surety to Final Payment ea LJ C)
e. Proof of Performance/Payment Bond 0 Oj
Continuation 12 Months Following :
Final Payment
Yes No
4. Agenda Request _ ca
5. Remarks
/ / -vb ba / ie.
DATE
Ashley S. Endris
From: Donald Turner <dturner@co.okaloosa.fl.us>
Sent: Friday, January 03, 2014 12:02 PM
To: Ashley S. Endris
Ce: Patti Hanna
Subject: RE: Skanska Final Payment
Yes, please make the change. Is there anything else FM needs to do to keep this item moving forward in the approval
process?
Sincerely,
Don
Donald L. Turner, Director
Facilities Maintenance
Office: (850) 689-5790
Fax: (850) 689-5630
From: Ashley S. Endris [mailto:aendris@clerkofcourts.cc]
Sent: Friday, January 03, 2014 9:53 AM
To: Donald Turner
Cc: Patti Hanna
Subject: Skanska Final Payment
A correction needs to be made to the contract payment form for the Skanska final payment. This correction is to code
for payment of retainage as follows:
3115-562170 $27,697.00
301-2051100 $10,000.00
Total $37,697.00
Please confirm that you would like me to make this correction.
Thank you,
Ashley
Ashley S. Endris
geek, Accountant
og* a's Okaloosa County Clerk of Circuit Court
33 fy -34 Contracts and Grants
", ?& 1804 Lewis Turner Boulevard, Suite 206
*ee9e?"* Ft. Walton Beach, FL 32547
Tel: (850) 651-7200 x 4382
Brenda L. Bailey | | a |
From: Brenda L. Bailey
Sent: | Monday, November 25, 2013 10:26 AM
To ee ‘dturner@co.okaloosa.fl.us'; Marcella B. Eubanks; Ashley S. Endris;
a6 'krossi@co.okaloosa.fl.us'; Patti Hanna (phanna@co.okaloosa.fl.us)
Ce . , Jack Allen; jkublik@co.okaloosa.fl.us
Action Item 2302
Subject:
Original Yocument package lacks Purchasing signature on Close-out Checklist.
a niepreeae oben
Title: Final Payment - SKANSKA
Department: Facility Maintenance
Category: Final Payment .
Meeting: Board of County Commissioners - Regular Meeting (North) - Tuesday, December 3, 2013 8:30 AM
pb “hk (noel vat
eee yy
ath sate | ;
Project Title: Construction Services - Construction of the Judicial Center
Skanska Lord Association
Purchasing Contract# C09-1698-ACAO
Expires: Upon Completion of Construction
3115 10%
562170 301-2051100 Amount
Invit Cost Withheld Paid
1 860,075.00 (3,704.00) 856,371.00
2 592,378.00 (36,128.80) 556,249.20
3 196,681.00 (19,668.10) 177,012.90
4 579,077.00 (57,907.60) 521,169.40
5 846,020.00 (84,602.00) 761,418.00
6 441,382.00 (44,058.70) 397,323.30
7 425,833.00 (42,577.70) 383,255.30
8 755,916.00 (75,575.30) 680,340.70
9 1,085,213.00 (108,521.30) 976,691.70
10 1,051,710.00 (104,958.10) 946,751.90
11 899,475.00 (89,940.60) 809,534.40
12 921,724.44 (91,971.44) 829,753.00
Subtotal 8,655,484.44 (759,613.64) 7,895,870.80
13°-* 840,215.21 (56,670.62) 783,544.59
14 622,195.35 5,792.26 627,987.61
15 722,257.00 (67,889.70) 654,367.30
16 728,996.00 (69,237.40) 659,758.60
17 727,562.00 (70,250.50) 657,311.50
18 574,465.00 (26,985.00) 547,480.00
19 894,690.00 (82,604.35) 812,085.65
20 335,335.00 171,469.70 506,804.70
21 101,698.00 (9,415.85) 92,282.15
22 5,933.00 308,727.15 314,660.15
23 203,988.00 646,677.95 850,665.95
24 27,697.00 10,000.00 37,697.00
Totals 14,440,516.00 (0.00) 14,440,516.00
Contract Total $ 22,400,229.00
Change Order 1 (3,964,977.00) ODP 001
Change Order 2 (2,118,456.00) | ODP 002
Change Order 3 (1,876,280.00)
Revised Contract Total $ 14,440,516.00
Balance to finish $ 0.00
Date
Paid
02/18/10
03/31/10
04/15/10
05/13/10
06/17/10
07/15/10
08/12/10
09/16/10
10/14/10
11/10/10
12/09/10
12/30/10
02/24/11
03/17/11
04/21/11
05/19/11
06/16/11
07/21/11
08/11/11
09/15/11
10/27/11
12/15/11
02/23/12
Check
Number
1003766
1005162&AJE6EI
1005492
1006371
1007293
1008049
V1008894
V 1009853
V1100322
V1101130
V1101990
V1102425
V1103828
V1104506
V1105475
V1106268
V1107038
V 1107967
V1108642
V1109514
V 1200623
V1201996
V 1203669
——
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TRY
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ERENT
CONTRACT/LEASE
PAYMENT APPROVAL FORM
COMPLETE AND FORWARD TO THE NEXT DEPARTMENT
== ——]
COMPLETED BY DEPARTMENT
pate: 07/12/2013
VENDOR NAME: Skanska USA Building, Inc. VENDOR #:
CONTRACT/LEASE#: CO09-1698- ACAO
necicd # ORDER # “PROJECT A pr Ananarier g| ACCOUNTS eee
(If Applicable) (Uf Applicable) 447, 697
24 ; Annex Extension 3115 562170 —-$-37,607,00—
Bo\ | 205100 | $10,600 AE
TOTAL $ 37,697.00
APPROVED FOR PROGRESS PAYMEN
CONTRACTOR'S ENGINEER/ARCHITECT/PROJECT MANAGER: DATE: 7 | 2 K4
COUNTY SUPERVISOR/PRQJECT DATE:
DEPARTMENT DIRECTOR: - DATE: ‘w]vel coy e.] ou Nas
CONTRACTS & GRANT MANAGER: DATE:
LZ) Z
COUNTY ADMINISTRATOR: =: LEE. DATE: y/: Wir,
7 (4
(Payments>S25,000.)
FINAL PAYMENT
FINAL PAYMENT ve(V wol_ | (If "Yes", forward to Purchasing Services Coordinator for Close-Out)
DATE: PURCHASING DIRECTOR:
(Per Initial Agreemeny)
DATE: \- 3- {4h CONTRACTS & GRANTS MANAGER:
- (All Contracts) ;
DATE: VA J Ss J / ‘- COUNTY ADMINISTRATOR APPROVAL: Jee
7 (Per Initial Agreement) 7
DATE: BOARD APPROVAL:
(Per Initial Agreement)
COMPLETED BY FINANCE - ACCOUNTS PAYABLE ONLY
FISCAL YEAR:
DATE RECEIVED:
REVIEWD BY:
cones
APPLICATION AND CERTIFICATION FOR PAYMENT AIA DOCUMENT G702 PAGE1 OF —2.—«~ PAGES
“TO OWNER: PROJECT: APPLICATION NO: 24 Distribution to:
Okaloosa County Board of Okaloosa County Courthouse DATE: 95/08/13
County Commissioners Annex Extension —
602-C North Pearl Street 1940 Lewis Turner Blvd. Ra OWNER
Crestview, FL 32536 Fort Walton Beach, FL 32547 PERIOD TO: 5/6/2013 X_ ARCHITECT
FROM CONTRACTOR: VIA ARCHITECT: “ X_]cONTRUCTION MANAGER
Skanksa USA Building Inc. Heery Design
55 Ivan Allen Jr. Boulevard, Suite 600
Atlanta, GA 30308
CONTRACT: Construction Manager
4700 Millenia Boulevard, Suite 550
Orlando, FL 32839
PROJECT NO: C09-1698-CAO
CONTRACT DATE: June 21, 2008
CONSTRUCTION MANAGER'S APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract.
Continuation Sheet, AIA Document G703, is attached.
1, ORIGINAL CONTRACT SUM $____22,400,229.00
2. Net change by Change Orders $ — =7,959,713.00:
3. CONTRACT SUM TO DATE (Line | + 2) $i 14,440,516.00
4. TOTAL COMPLETED & STORED TO $ 14,440,516.00
DATE (Column Gon G703)
5. RETAINAGE:
a. of Completed Work 0.00
(Column D + E on G703)
b._ of Stored Material 0.00
“(Column F on G703)
Total in Column I of G703) $ 0.00
6. TOTAL EARNED LESS RETAINAGE $ ~ 14,440,516.00
(Line 4 Less Line 5 Total)
7, LESS PREVIOUS CERTIFICATES FOR
PAYMENT (Line 6 from prior Certificate) $ 14,402,819.00
8. CURRENT PAYMENT DUE $e 31,697.00.
9. BALANCE TO FINISH, INCLUDING RETAINAGE , ae 0.00
(Line 3 less Line 6)
CHANGE ORDER SUMMARY | ADDITIONS | DEDUCTIONS |
Total changes approved
in previous months by Owner 0.00 -6,083,433.00}
Total approved this Month 0.00 sini onianl
TOTALS 0.00] -7,959,713.00]
NET CHANGES by Change Order -7,959,713.00
ARCHITECT'S CERTIFICATE FOR PAYMENT
The undersigned Contractor certifies that to the best of the Contractor's knowledge,
information and belief the Work covered by this Application for Payment has been
completed in accordance with the Contract Documents, that all amounts have been paid by
the Contractor for Work for which previous Certificates for Payment were issued and
payments received from the Owner, and that current payment shown herein is now due.
Construction Manager: Keith Shelton, Senior Project Manager RP
Skanska USA Building Inc. RX RA | HU NV Ker
By: Kewh WW Date: 28748 BSS: Gur A
= #0 of 4
State of: Georgia = is aig oF <:
Subscribed and swom to before me this day of May DID . eg © iO:
Notary Public: aan s Sik, UBL st &:
a * ‘d
My Commission expires: > sy 5 Suse Oo
Nin aa
In accordance with the Contract Documents, based on on-site observations and the data i
comprising the application, the Architect certifies to the Owner that to the best of the
Architect's knowledge, information and belief the Work has progressed as indicated,
the quality of the Work is in accordance with the Contract Doctments, and the Contractor
is entitled to payment of the AMOUNT CERTIFIED.
(Attach explanation if amount certified differs from the amount applied. Initial all figures on this
Application and onthe Continuation Sheet that are changed to conform with the amount certified.)
ARCHITECT. Robert Egleston, Executive Associate
AMOUNT CERTIFIED ........... $
epy Design / |
This Certificate is not negétiat . The AMOUNT CERTIFIED is payable oly to the
Contractor named herein. Issudnce, payment and acceptance of Payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
AIA DOCUMENT G702 - APPLICATION AND CERTIFICATION FOR PAYMENT - 1992 EDITION « AIA - ©1992
THE AMERICAN INSTITUTE OF ARCHITECTS, 1735 NEW YORK AVE., N.W., WASHINGTON, DC 20006-5292
CONTINUATION SHEET
AIA DOCUMENT G703 PAGE 3 OF 3 PAGED
AIA Dooument G702, APPLICATION AND CERTIFICATION FOR PAYMENT, containing "APPLICATION NO: oY]
Contractor's signed certification is attached. APPLICATION DATE: 05/08/13
In webulations below, amounts are stated to the nearest dollar. PERIOD TO: 05/06/13
Use Column 1 on Contracts where variable retainage for line items may apply. OKALOOSA COUNTY PROJECT NO: C09-1698-CAO
a_|B Cc D E F G H 1
trem |DESCRIPTION OF WORK SCHEDULED CHANGE REVISED WORK COMPLETED MATERIALS TOTAL * BALANCE RETAINAGE
NO. VALUE ORDER CONTINGENCY SCHEDULED | FROMPREVIOUS[ ~—~STRISPERIOD | PRESENTLY COMPLETED G+C) TO FINISH (CF VARIABLL
VALUE APPLICATION STORED AND STORED (C-@) aT
(+E) (NOT IN TO DATE
DORE) (Q+E+E=)
1 ]Sitework 1,851,376.00 (1,349,489.00) 501,887.00 501,887.00 501,887.00 100%
2 |Demolition 59,257.00 ($9.257.0)
3 [Earthwork & Site Utilities 692,976.00 (78,352.00) 614,424.00 614,424.00 614,424.00 100%
4 [Reinforced Concrete 408,074.00 (408,074.00)
5 {Cement Finishing
6 | Tilt-Up Concrete $27,490.00 110,854 00) 816,636.00 816,636.00 816,636.00 100%
7 ‘|Masonry 488,626.00 118% 498,00) 300,128.00 300,128.00 300,128.00 100%
8 1S I and Misc. Steet 974,162.00 (456,019.00) 518,143.00 518,143.00 518,143.00 100%
9 |Rough Carpentry 56,700.00 (56,706.00)
10 }Millwork 1,159,880.00 (833,376,005 326,504.00 326,504.00 326,504.00 100%
11 | Waterproofing and Caulking 297,350.00 (169,522 00) 127,828.00 127,828.00 127,828.00 100%
12 | Roofing and Sheet Metal 430,709.00 (237,051 00) 193,658.00 193,658.00 193,658.00 100%
13. }Hollow Metal 549,702.00 (419.394.00) 130,308.00 130,308.00 130,308.00 100%
14 [Wood Doors 15,334.00 ss
15 |Special Acting Doors 21,308.00 (14,516.00) 6,798.00 6,798.00 6,798.00 100%
16 | Finish Hardware 2,000.00 (2,000.00)
17 }Glass, Glazing, and Storefront 699,035.00 (199,710 0G) 589,325.00 589,325.00 589,325.00 100%
18 [Lath, Plaster, and Stucco
19 [Drywall 640,770.00 (17.68 1,00) 623,089.00 623,089.00 623,089.00 100%
20 {Ceramic Tile 77,650.00 (49.311.00) 37,339.00 37,339.00 37,339.00 100%
21 |Acoustical 362,868.00 (362,868.00)
22. {Resilient Floors 268,150.00 (161,397.00) 106,753.00 106,753.00 106,753.00 100%
23 | Painting and Wall Covering 261,886.00 11,654.00 273,540.00 273,540.00 273,540.00 100%
24 |Special Flooring 211,932.00 (71,899.00) 140,033.00 140,033.00 140,033.00 100%
25 |Miscellancous Specialties 173,976.00 (108.170,00) 65,806.00 65,806.00 65,806.00 100%
26 | Toilet Partitions and Accessories 77,186.00 (77,186.00)
27 | Equipment 3,350.00 (3,350.00)
28 |Signage 115,024.00 115,024.00 115,024.00 115,024.00 100%
29 | Casework
30
