Okaloosa County BOCC — 2013 meeting #1182 (date undetermined) — FINAL INVOICES AND CONTRACT CLOSE-OUT CHECKLIST — reading text

CONTRACT CLOSE-OUT CHECKLIST (To Be Prepared by the Purchasing Services Coordinator) DATE: _ 11/13/13 TO: Contracts & Grants Manager, Finance Department Contracts & Grants Office SUBJECT: Contract No. C09-1695-WS MANAGING DEPARTMENT: Water & Sewer CONTRACTOR'S NAME: Electric Motor Repair Service PROJECT TITLE: The attached has met the final payment contract requirement in subject contract. Yes No 1. Final Invoice ca CJ 2. Completed Contract/Lease Payment Approval Form O 3. Close-Out Documents Yes No N/A a. Signed Release of Lien im O b. Proof of Completion Advertisement CL] C] c. Certificate of Insurance C] im d. Consent of Surety to Final Payment C] | a e, Proof of Performance/Payment Bond O CC Continuation 12 Months Following Final Payment No ~< @ ”“ ~ Oo 4. Agenda Request 5. Remarks fe iM /)-/4 “£3 or DATE Electric Motor Repair Service Phone # Invoice 850-862-0433 ' 90 Skipper Avenue _ Fort Walton Beach, FL 32547 Fax # a | Date _|| Invoice # , 850-863-792 7/8/2013 12414 - BIN To Ge Okaloosa County Water & Sewer : Att: Sewer Plant : 1804 Lewis Turner Blvd. Fort Walton Beach, FL 32548 P.O. No. Control. No. Terms Due Date 10th Next Month 8/10/2013 _ item Description Quantity Rate Amount Recondition | Consisting of : Rewind field windings / 810.00 810.00 © Upper Thrust Bearing / Lower Guide Bearing / Labor 50 HP Vertical Hollowshaft ID# R-6232-01-790 ROO9633 Mark Loc: Newcastle Retention Pond Cont# C09-1695-WS 1- F-> He 72 P aha) > Subtotal $810.00 Sales Tax (6.0%) $0.00 | Total : $810.00 ~) oN Electric Motor Repair Service Phone #- Invoice . 850-862-0433 90 Skipper Avenue — Fort Walton Beach, FL 32547 Fax # | —Date—_|| Invoice # 850-863-7929-1 1" syopoi3’ \) 12438 “ Bill To a Okaloosa County Water & Sewer Att: Sewer Plant 1804 Lewis Turner Blvd. . Fort Walton Beach, FL 32548 P.O. No. Control.No. Terms Due Date 10th Next Month 8/10/2013 item Description Quantity Rate Amount Recondition | Load Bearing / Guide Bearing/ 2,610.00 2,610.00 Mechanical shaft seals / O-ring kit / Oil / Labor 20 HP Wemco Reliance ID# 6824448 EH T2 MARK Loc: Browns Place Contract# C09-1695-WS Lae vté AT Li STAN $A VL +2 Ps 5 2 | “ETVIB IZ Subtotal $2,610.00 Sales Tax (6.0%) $0.00 Total $2,610.00 lth Not Paid yet Flease Check. on thes Electric Motor Repair Service Phone # Invoice 850-862-0433 90 Skipper Avenue = Fort Walton Beach, FL 32547 Fax # _Date__|| Invoice # Ly a . 850-863-7929 7/31/2013 , 12455 Bill To ae Okaloosa County Water & Sewer “|Att: Sewer Plant 1804 Lewis Turner Blvd. Fort Walton Beach, FL 32548 P.O. No. Control No. Terms Due Date 10th Next Month 8/10/2013 Item Description Quantity | Rate Amount Recondition | Consisting of: Rewind field windings / 810.00 810.00 4+~ Thrust Bearing / Guide Bearing / Labor 50 HP Hollowshaft Motor Model # BF54A Mark Loc: Newcastle Retention Pond - 2nd Contractit C09-1695-WS fer # fet P fe O42 Pe +) -< -)- 19. Subtotal $810.00 Sales Tax (6.0%) $0.00 Total $810.00