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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

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