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CONTRACT CLOSE-OUT CHECKLIST
(To Be Prepared by the Purchasing Services Coordinator)
DATE: October é, 2016
TO: Contracts & Grants Manager, Finance Department Contracts & Grants Office
SUBJECT: Contract No. C07-1468-1S
MANAGING DEPARTMENT: IS
CONTRACTOR'S NAME: Centurylink
PROJECT TITLE: Information Technology
The attached has met the final payment contract requirement in subject contract.
Yes No
1. Final Invoice X /
2. Completed Contract/Lease Payment Approval Form E@fi/ K\Wfi/
3. Close-Out Documents Yes No N/A
a. Signed Release of Lien ] O] X
b. Proof of Completion Advertisement ] O X
c. Certificate of Insurance [l ] X
d. Consent of Surety to Final Payment L] ] X
e. Proof of Performance/Payment Bond ] ] X
Continuation 12 Months Following
Final Payment
Yes No
4. Agenda Request
Sy
=
N
5; Remarks
Marcella B. Eubanks
From: Zan Fedorak <zfedorak@co.okaloosa.fl.us>
Sent: Monday, October 10, 2016 1:31 PM
To: Marcella B. Eubanks
Cc: Jane H. Evans; Mindy Kovalsky
Subject: RE: Action Item 6316 was Reviewed : Final Payment CenturyLink C07-1468-IS
My apologies Marcella. Please make the change on the form.
Thanks
Zan
From: Marcella B. Eubanks [mailto:meubanks@okaloosaclerk.com]
Sent: Monday, October 10, 2016 1:29 PM
To: Zan Fedorak <zfedorak@co.okaloosa.fl.us>
Cc: Jane H. Evans <jevans@okaloosaclerk.com>; Mindy Kovalsky <mkovalsky @okaloosaclerk.com>
Subject: FW: Action Item 6316 was Reviewed : Final Payment CenturyLink C07-1468-IS
Good afternoon, Zan.
We are in receipt of the attached agenda package.
It includes a Contract Close-Out Checklist item 2 indicates “No” although we do have a Completed Contract/Lease
Payment Approval Form and item 5 Remarks is unanswered.
Please advise.
Thank you
Marcella B. Eubanks
Contracts and Grants Manager, CPM
: 4 Okaloosa County Clerk of Circuit Court
{ . ¢ % Contracts and Grants
S &T : 302 N. Wilson Street, Suite 203
Crestview, FL 32536
Tel: (850) 689-5000 x 4381
Fax: (850) 689-5882
wvag
From: Dan Sambenedetto [mailto:NoReply@IQM2.com]
Sent: Monday, October 03, 2016 4:39 PM
To: Marcella B. Eubanks <meubanks@okaloosaclerk.com>; Ashley S. Endris <aendris@okaloosaclerk.com>; Mindy
Kovalsky <mkovalsky@okaloosaclerk.com>; Jane H. Evans <jevans@okaloosaclerk.com>
Cc: dbroadway@co.okaloosa.fl.us
Subject: Action Item 6316 was Reviewed : Final Payment CenturyLink C07-1468-IS
Stage #1 of this Action Item has been Reviewed by Dan Sambenedetto and now needs to be reviewed by:
Marcella Eubanks. Click here to Review online
1
[ITIRequest approval of final payment, contract #C07-1468-1S, CenturyLink. Dist: All
ATTACHMENTS
e FinalPaymentC07-1468-1S
INFORMATION
Department: Information Technology
Category: Final Payment
Meeting: Oct 18, 2016 6:00 PM - Board of County Commissioners
Court emy
communic
ons
CONTRACT/LEASE
PAYMENT APPROVAL FORM
I COMPLETE AND FORWARD TO THE NEXT DEPARTMENT |
Il 1]
COMPLETED BY DEPARTMENT
DATE: 09/26/2016
VENDOR NAME: CenturyLink VENDOR #: 015765
CONTRACT/LEASE #: C07-1468-IS
VENDOR TASK COUNTY/FEMA BUDGET ACCOUNT # AMOUNT $
INVOICE # ORDER # PROJECT # DEPARTMENT #
(If Applicable) (If Applicable)
312122231 0114 541010 $3.673.68
09/16/2016
TOTAL $3.673.68
APPROVED FOR PROGRESS PAYMENT (please sign. as applicable and date
CONTRACTOR’S ENGINEER/ARCHITECT/PROJECT MANAGER: DATE:
COUNTY SUPERVISOR/PROJECT MANAGER: L B DATE: -
DEPARTMENT DIRECTOR: > MVM DATE: 2 ? 7/7" M’
CONTRACTS & GRANTS MANAGER: DATE:
COUNTY ADMINISTRATOR: DATE:
(Payments > $25,000.)
L 1]
FINAL PAYMENT
FINAL PAYMENT YES NO |:] (If “Yes”, forward to Purchasing Services Coordinator for Close-Out)
DATE: Ig%[g . PURCHASING DIRECTOR: -Zfiu,( ;\fbf(fiihcj(
77
(Per Initial Agreement)
DATE: /f0 "40"/é CONTRACTS & GRANTS MANAGER:
(All Contracts)
DATE: /N COUNTY ADMINISTRATOR APPROVAL:
(Per Initial Agreement)
DATE: BOARD APPROVAL:
y (Per Initial Agreement) Charles K. Windes, Jr., Chairman
I 11
COMPLETED BY FINANCE - ACCOUNTS PAYABLE ONLY
FISCAL YEAR:
DATE RECEIVED:
REVIEWED BY:
Account Name: OKALOOSA CTY FLORIDA FINANCE D
Account Number: 312122231
P.O. Box 1319 Page: 1 of 199
Charlotte, NC 28201-1319 Bill Date: Sep. 16, 2016
Previous Payments Adjustments Current IMPORTANT NEWS
Balance Credits Charges
| 5,817.98 | 4,105.80 CR | 1,838.96 CR I 6,830.14
Payment Summary
Previous Balance 5,817.98
Payment by check received on AUG 31 4,105.80 CR
Balance 1,712.18
Adjustments/Credits Summary
Adjustments to Previous Balance (Details on Page 3 ) 1,838.96 CR
Total Adjustments 1,838.96 CR
Current Charge Summary
Monthly Charges 5,264.70
One-Time Charges 250.00
Usage Charges 1,150.26
Discount 0.00
Adjustments 4.00 CR
Taxes, Fees, and Surcharges 169.18
5 vl g O 5 S A
Total Current Charges 6,830.14 Lo T Foay Tkt BlP(D : i‘
Due Date Oct. 07, 2016 Amount Due 6,703.36 : q :
oy only 2 3613, 4,6
Otildy By -
o Cortraed
**PLEASE FOLD, TEAR HERE AND RETURN THIS PORTION WITH YOUR PAYMENT***
FOR CHANGE OF ADDRESS OR PAYMENT AUTHORIZATION:
Please check here and complete reverse. Thank You.
OKALOOSA CTY FLORIDA FINANCE DEPT
302 N WILSON ST
CRESTVIEW, FL 32536-3473
Account Number: 312122231
Amount Due By Oct. 07, 2016 _6,703:36
2 13,67
/
CenturyLink
P.O. Box 1319
Charlotte, NC 28201-1319
000031212223130000000000000000000000091616000067033696000000
P.0. Box 1319
Charlotte, NC 28201-1319
Account Name: OKALOOSA CTY FLORIDA FINANCE D
Account Number: 312122231
Page: 2 of 199
Bill Date: Sep. 16,2016
Important Notices and Information :
Allocation of charges:
Service Categories Past Due Current Month Total Due
Basic Services 0.00 5,239.74 5,239.74
Other Services 126.78 CR 1,590.40 1,463.62
All Services 126,78 CR 6,830.14 6,703.36
Failure to pay Basic charges may result in the disconnection of those Services. Please contact
CenturyLink regarding any questions or problems with your bill before the due date.
Third-Party Billing Block
Cramming occurs when unauthorized charges appear on your telephone bill. To help prevent unwanted third
party charges on your bill, contact CenturyLink and request, at no charge, a bill block that will prevent
some third party charges such as charitable contributions, dial-up Internet by non-CenturyLink companies or
other non-telecommunications charges from appearing on your bill.
CenturyLink works every day to bring you solutions that best meet your total communications needs, Stop in
and learn more about our value pricing that will help you reduce your household expenses when you bundle all
of your services with CenturyLink. You can also pay your bill and check out our newest products and services
at your local CenturyLink Customer Experience Center. Visit www.centurylink.com/stores to find the location
nearest you.
EMBARQ Florida, Inc. DBA CenturyLink
LATE FEE REMINDER: L ate fees may be charged each month for any eligible unpaid balances
not paid in full by the due date listed on your bill. The methods for calculating late fee amounts vary by
state and product. For more information you may access Terms and Conditions and Tariff materials at
http://www.centurylink.com/tariffs.
CenturyLink should be notified within 90 days after the CenturyLink Bill Date of any billing discrepancies on
your statement.
FREE Enroliment] With CenturyLink's My Account service, you can update your billing information, view and pay
your bill and much more. Visit us online at www.centurylink.com/myaccount,
Immediate Billing Address Changes Call 1-800-786-6272
312122231
OKALOOSA CTY FLORIDA FINANCE DEPT
302 N WILSON ST
CRESTVIEW, FL 32536-3473
Address Information Changes Effective Date
New Address
City State Zip
Work Phone ()} Home Phone ( )
MONTHLY AUTOPAY AUTHORIZATION FORM
| authorize Centurylink to charge my MasterCand, Visa, Discover,
savings or checking account monthly for any accrued balance
on the billing account listed below.
(We reserve the right to revoke this if bank approval is denied)
I:] Checking Account #
(Write your billing account number on a voided check or copy of a
voided check and attach.)
D Savings Account #
(Write your bilfing account number on a voided deposit slip and attach.)
[Jcredit Card [ |DebitCard Exp Date:
D MasterCard [ _|Visa [ ] Discover
Slignature required Date
Please continue to our bill until notified on your statement
that autopay is actie:y y Y
Account Number
|
P.O.Box 1319
Charlotte, NC 28201-1319
Detail of Payments and Adjustments
Detail of Adjustments {Reflected on Page 1)
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
L.ong Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Long Distance Credit / 850-651-7340
Total Adjustments
Account Name: OKALOOSA CTY FLORIDA FINANCE D
Account Number: 312122231
Page: 20 of 199
Bill Date: Sep. 16, 2016
1.37 CR
2,05 CR
0.69 CR
1.37 CR
0.68 CR
0.69 CR
0.68 CR
4.81
1.37
8 8
3.43
Y
1.37 CR
5.49 CR
2.06 CR
2.05 CR
0.6% CR
2.05 CR
1.87 CR
1.37 CR
0.69 CR
0.68 CR
0.69 CR
0.68 CR
1,838.96 CR
Current Charges Summary
Monthly Charges
Do fuet Q::«q\
G "N ABENSOL 2D G2
[A‘dd Block Of 20 Numbers FromAUG 16 To SEP 18
Add Block Of 20 Numbers From JUL 16 To AUG 15
Add Facility Relocation Fee BUS From AUG 16 To SEP 15
Add Fagiiity Relocation Fee BUS From JUL 16 To AUG 15
Add Fed Universal Service Chg From AUG 16 To SEP 15
Add Fed Universal Service Chg From JUL 16 To AUG 15
Add ISDN PRI 60 Month Term From AUG 16 To SEP 15
Qdd ISDN PRI 60 Month Term From JUL 16 To AUG 15
Additional DID Each
Additional Listing-Bus
Block Of 20 Numbers
Extra Line-Bus
Fadility Relocation Cost Recovery Fee
Fed Universal Service Chg
Federal Subscriber Line & Access Recovery Charge
ISDN PRI 60 Month Term
L1506 20
Add Federal Subscriber Line & Access Recovery Charge From AUG 16 To SEP 15
Add Federal Subscriber Line & Access Recovery Charge From JUL 16 To AUG 15
Qty Rate
1@ 4.00
1@ 4,00
2@ 1.00
2@ 1.00
2 @ 1.42
2@ 1.42
2@ 9.63
2@ 9.63
2 @ 425.00
2@ 425,00
8 @ 1.50 12.00
10 @ 3.50 35.00
1@ 4,00 4.00
8 @ 3.60 21.00
7@ 1.00 7.00
27 @ 1.42 38.34
27 @ 9.63 260.01
6 @ 425.00 2,550.00
Account Name: OKALOOSA CTY FLORIDA FINANCE D
Account Number: 312122231
P.O. Box 1319 Page: 21 of 199
Charlotte, NC 28201-1319 Bill Date: Sep. 16, 2016
Service From Sep. 16, 2016
Current Charges Summary
Monthly Charges Qty Rate Amount
Long Distance Line Charge 7@ 5.15 36.05
Mileage 1@ 56.50 56.50
Mileage 8 @ 14.20 113.60 i
PRI Access Line 1@ 23.27 23.27
PRI Access Two-Way 1@ 39.73 39.73 i
PRI B Channel 23 @ 13.00 299.00 !
PRI D Channel 1@ 13.00 13.00
Total Monthly Charges §,264.70 Nb\/
One-time Charges
Premise Visit Bus 260.00 @ y
Total One-time Charges ! 250,00 fi \
Usage Charges Calls Mins
AT&T Charges 1 3.1
" Enhanced Voice Sol - $12000 YR Min 3 Year Term 11315 37229.4
intemational W(/ "}D [ 31 135.3 C.]OMZZH
Total Usage Charges w ?_)T "\ 11347 37367.8 tsby
Adjustments |
Remove Facility Relocation Fee BUS From AUG 16 To SEP 15 2,00 CR |
Remove Fadility Relocation Fee BUS From JUL 16 To AUG 15 2.00 CR
) Total Adjustments 4.00 CR
Taxes, Fees and Surcharges !
Federal Property Tax Recovery Fee 12.42
Federal Regulatory Recovery Fee 2.32 ]
Federal Telecommunications Relay Fee 15.23 |
Federal Universal Service Fund Surcharge 139,21 '
Total Taxes, Fees and Surcharges 169.18
Total Current Charges 6,830.14
Contact Numbers
www.centurylink.com/myaccount
1-866-712-199¢6 Pay by Phone
1-800-786-6272 Customer Service
1-800-786-6272
