Okaloosa County BOCC — June 3, 2014 — Genesis Final C#0088 signed by purchasing — reading text

service failures, should be submitted by going to www.tedex.com or calling 800.622.1147. Please use multiple forms for additional requests. ¢ Please complete ail fields in black ink. f RequestorNemeL Lt Ltt itil ilies tt teri bed dt td patel Ly Li dy Li t ‘® Phone LELEIJ-LIBLI-Lbt 1 rexea Lt FeLi -LEL c E-mail Addrass TWes, 1 want update eccount contact with the above information ry Tracking Number Bill ta Account $ Amount eLILtTIitittbtt ty LLititt ti) LLL Iii brea (etek TE | LLL tt t-Lit ¢LLLititttittitiy Litlitit is Litti}-Lty TLELED tet ptt tt | Liipitetid LLLityj-tti SLLLLitiitttititteys Litivitti) LLL yt ADR Address Cortactisn ~~ (NW-Incorrect Weight OVS - Oversize Surcharge For ail Service failures or other DVC - Déclared Value INS - Incorrect Service RSU - Residential Delivery surcharges please use our web JAN ~ Invalld Acct # OCF - Grd Pick-up Fee PND - Pwrshp Not Delivered site www fedex.cam or call ia OCS - Exp Pick-up Few SDR - Saturday Delivery (800) 622-1147 Rerate information only {round to nearest incht c Tracking Number Code $ Amount LBS L Ww H t — GLb edb bel We bot PP LLL Lit bt eb pL IL ett xt tt PLELELILEPt re titi Ga LEE ai feLb La LEE xb t bet CLELTELi ti ttre tit sy CEL DELL Lo CL xt betty SEP ETTT TPP tt tt tt LE LEE yeL bE EEL elit jxL i LEE Lidice tr iets LEE) CELLED LEI LL LILE xt it ixLtl Check all that apply Effective Date f i A CShipping Address (Physical Address) CBitling Address Only {]Billing Same As Shipping Address 4 company LLL LEP LEP PP PEL id |eompoy LLELttttititisiiis waddess LLL Lt ti tit bi bb tt jaoaross CLE LP ba Pte ee Et SAdmess LET EP ELL EYEE PIPL) addres LLL LEP EYP ete td ge oooe LE LIP E PEt tit ttt ty oom Litptriittptitiyiiy Foor LLLLitLy aovsuites LLE LT ror Littit apvevtee LIL i | acy LLELLti Litter tit td cy bFLLLLEDELEtTtE tii tty 8 soo CLA tiptoe LEE E IL -LE dE ste LES zipcode LEA 11 LLL * phono L}1J-Lit|-LLtiI Phons 1.J-LLiJ-LLJ41 Fox# LELJ-LLLI-LLLis Fax oJ -LLiS-LLtit Tavoice Number Invoice Date Account Number, Page 2-477 -52130 Nov 26, 2013 1277-70735 ee FedEx Tax iD: 71-0427007 Shipping Address; GENESIS GROUP GENESIS GROUP 9922 TAPESTRY PARK CIR STE 201 JACKSONVILLE FL 32246-9260 Invoice Summary Nov 26, 2013 9822 TAPESTRY PARK C1 STE 201 JACKSONVILLE FL 32246-9260 {nvoice Questians? ; Contact Fedex Revenue Services Phone: (800) 622-1147 M-Sa7-6 (CST) Fax: (800) 548-2020 Internet wwwfadex.com Fed ress Services Transportation Charges 14.19 Base Discount +240 Bonus Discounts “ab Spacial Handling Charges 1.03 Total Charges usd $11.32 TOTAL THIS INVOICE usb $11.32 ‘You saved 5261 in discounts this pariodt ‘Shipments included in this invoice received an earned discount, (f you ‘would like to Know how it was calculated, please go to the following URL: https:vivawws fedex convEarnedDiscounts Other discounts may apply. roan 264 029 moro FF2, a poeta bs ¥i0 oes 2 ite) oun Nove n Aeh9—— Detailed descriptions of surcharges can be located at fedex.com Soosmepuerge eanientninwioceareewisis (Tqygice Number \[~ Account Number Amount Due 5 Farchangeol aks, check sd canine orm on vers ie 2-477-52130 1277-7073-5 USD $13.32 Remittance Advice ‘Your payment is due by Dec 11, 2013 2277707324 7752 1302 700000213204 0023106 orarorm waves amram mzwsnnsy consist eet lett a etal ‘GENES GROUP 9672 TAPESTRY PARK GIR STE 207 “JACKSONVILLE FL. 3206 9280 in ec FedEx P.O. Box 660481 DALLAS TX 75268-0481 ao my imormemznasamzeatan Staff Type Senior Land Use Planner Regulatory Specialist Graphics Specialist Landscape Architecture Administrative REFER 3 PRINTED/ATTACHED BY: BCC FINANCE GENESIS GENESIS GRO one Standard Hourly Rate Schedule (Okalooss County Contract # C91-0088-TDI-05) (Valid through December 31, 2013) Hourly Rate $90.00 $45.00 $75.00 $40.00 Okaloosa County Clerk of the Circuit |_ Court *""PLEASE RETURN YELLOW FORM M e mo WITH THE RESUBMITTED CONTRACT" To: — ECCC oN ns Please note. Finance cannot make payments Brom: oii Gates, Haile s-aoes Manan for invoices uniess all charges are correct and Date: 03/03/14 contractual, We are experiencing continuing Re: ‘Retum Paymee Remuest Notification problems with corrections to future billings not being made by the vendor or departments REFERENCE MATERIAL: © The County's Policy and Procedure Manual and forms are available online at ttp://www.co.okaloosa.f],us/Purchasing_Documents.hum!. + All contracts/leases can be viewed at httpy//www?.co.okal us/comtracts/defaultpage.aspx. ‘THE FOLLOWING PAYMENT REQUEST IS BEING RETURN DUE TO ONE OR MORE OF THE FOLLOWING REASONS: C1 Pricing/rates are not contracted values. Confirm, 11 Invoiced items not covered under contract, ‘ce removed from contract payment form for the following reason: woice #:__ 53627 Invoice Date: 01/17/2014 Invoice Amount__§ 216.52 [Need lnvoicosuppert do umeriation for Fed-Ex OD other ***4NOTE: 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 and make necessary corrections and resubmit for payment, Ifyou have any questions, contact Olivia ‘Tanner at x3414 or Jodi Gates at x3413, Thank you, Logged e : CONTRACT/LEASE PAYMENT APPROVAL FORM COMPLETE AND FORWARD TO THE NEXT DEPARTMENT. COMPLETED BY DEPARTMENT DATE: ozzong Ti VENDOR NAME: ___Genesis Grou ‘és 8408 CONTRACTLEASE #: C91-6088-TDC [VENDOR TASK COUNTY/FEMA BUDGET ACCOUNT # | AMOUNTS INVOICE# | ORDER# PROJECT # DEPARTMENT # (if Applicable) (if Applicable) 332047 2. | OO83-ad iti) 562752 si.s20.s0l~ 332927, 27 | YRS -AT 179 5637907 $7,231.68|7 =e? |Vihind gl PAGES = SEE ae Pea CAL 008S 1179 5627907 5135.00} =o [(Gunnel he opt 1741008 HH =sea7sr7 ~sa162} 525877 CH16033. 1179 563790 $2,234.70] —s2596-—[ (auined To opt] CAT CORE 5 2 8 53468 7 CALOOSY 1179 5627527 $595.65] TOTAL) _-s13.235.66} N819.03 on APPROVED FOR PROGRESS PAYMENT (Please si icable ans CONTRACTOR'S ENGINEER/ARCHITECT/PROJECT Magi DATE: COUNTY SUPERVISOR PROIECT MANAGER: DATE: O% DEPARTMENT DIRECTOR: DATE: a 2 Qh CONTRACTS & GRANTS MANAGER: DATE: 2 2 Of, COUNTY ADMINISTRNTOR: DATE: Payments>825,000) y= Ta FINAL PAYMENT aS FINALPAYMENT “ YES__NO___ Af "Yes", forward fo Purchasing Services Coordinator for Clase-Out) peo 4 DATE: = PURCHASING DIRECTOR (Pepi Agreemens DATE: CONTRACTS & GRANTS MANAGER —" games ~ ne CER kararon Or A (Per Initial Agreement} a DATE: BOARD APPROVAL {Per bail Agreement) ‘LETED BY FI ICE - ACCO -AVABLE ONL! er a CI 0088 Tee ell oe ARLA 1O/3]13 Cortiact out of date. Ail invottes included s@-qhis par pare rts. the Services were fenderecL pnoy to enpivortiow YD noe