HomeMy WebLinkAboutDocumentation_Pension General_Tab 07_05/03/2010 VILLAGE OF TEOUESTA CHECK REQUEST
Vendor # Date: vi mail Return to Dept.
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Total
Requested By: Approved By �! m
(Department Head)
Special Instructions:
REQUESTS RECEIVED IN FINANCE BY TUESDAY AT 5:40 PM WILL BY
AVAILABLE. FOR DISTRIBUTION BY THE FOLLOWING MONDAY AT NOON.
PLEASE PLAN YOUR REQUESTS ACCORDINGLY'.
WP80\MyFiles\Check Request
BUSINESS SERVICES CONNECTION, INC.
260 Riverside Drive, Palm Beach Gardens, FL 33410
561 -694 -7963
Fax: 561 - 694 -1591
January 15, 2010
Invoice No. 10 -3
TO: General Employees' Pension
INVOICE
Office work for week ended January 8, 2010 ...................3.75 hrs
Office work for week ended January 15, 2010 ...................3.75 hrs
'3 b,
7.50 hours �
Total Due ..................................... ............................... $267.60
Please make check payable to:
Business Services Connection, Inc.
260 Riverside Drive
Palm Beach Gardens, FL 33410
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Special Instructions:
REQUESTS RECEIVED IN FINANCE BY TUESDAY AT 5:00 PM WILL BY
AVAILABLE. FOR DISTRIBUTION BY THE FOLLOWING MONDAY AT NOON.
PLEASE PLAN YOUR REQUESTS ACCORDINGLY!
WP80\MyFi1es \Check Request
BUSINESS SERVICES CONNECTION, INC.
260 Riverside Drive, Palm Beach Gardens, FL 33410
561 - 694 -7963
Fax 561- 694 -1591
TO: General Employees Pension Invoice No. 10 -7
INVOICE
Office Work for week ended January 22, 2010 ................ ...........................3.75 hrs
Office Work for week ended January 29, 2010 ................ ...........................3.75 hrs
7.50 hours @$35.68
TotalDue ........................................................ ............................... ........................$267.60
Please make check payable to:
Business Services Connection, Inc.
260 Riverside Drive
Palm Beach Gardens, FL 33410
VILLAGE OF TEGUESTA BOARD OF TRUSTEE'S
1242
GENERAL EMPLOYEE'S PENSION TRUST FUND
345 TEOUESTA DRIVE (/ & TEQUESTA, R 33469 DATE � �'r � imlvo
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VILLAGE OF TEOUESTA CHECK REQUEST
Vendor # Date: / / Rail Return to Dept.
Vendor Name: 4 4 1
Address:
Reason for Request: (Pease attach appropriate documentation)
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Charge to Account No. 6 L 0 60 , 3 - - 3 'Amount:
Total f . 3
Requested ley: Approved By:
(Department Bead)
Special Instructions:
BEQUESTS DECEIVED IN FINANCE BY TUESDAY AT 5:00 PM WILL BY
AVAILABLE. FOR DISTRIBUTION BY THE FOLLOWING MONDAY AT NOON.
PLEASE PLAID YOUR REQUES'T'S ACCORDINGLY!
WP80\MyFAes \Check Request
BUSINESS SERVICES CONNED I IUN
260 RIVERSIDE DRIVE, PALM BEACH GARDENS, FL 33410
561 - 694 -7963
Fax 561 - 694 -1591
February 12, 2010
TO: General Employees Pension
INVOICE NO. 10 -12
INVOICE
Office Work for week ended February 5, 2010 .......... ..............................0
Office Work for week ended February 12, 2010 ........ ...........................3.75 hrs
3.75 Hours @ $35.68
TotalDue ............................ ............................... ........................$133.80
Please make cnecK payable to:
Business Services Connection, Inc.
26U Riverside Drive
Palm Beach Gardens, FL 33410
1243
VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S
GENERAL EMPLOYEE'S PENSION TRUST FUND
345 TEQUESTA DRIVE
TEQUESTA, FL 33469 DATE i Q 63- 1312"
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PAY TO THE w�J /G ' ) �/y,, ,►,,�
ORDER OF �vG�/ �� CjO'�// G � ter// -( 193. eo
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VILLAGE OF TEQUESTA CHECK QUEST
Vendor # Date: 61 bail return to Dept.
Vendor Name:
Address:
Reason for Request: (Please attach appropriate documentation)
Charge to Account No. 6 b Z 0,3 d. 5 ' Amount:
Total
Requested By: S Approved 13y:
(Department Mead)
Special Instructions:
REQUESTS RECEIVED IN FINANCE BY TUESDAY AT 5:.00 PM WILL BY
AVAILABLE, FOR DIS'TRIBUT'ION BY THE FOLLOWING MONDAY AT NOON.
PLEASE PLAN YOUR REQUES'T'S ACCORDINGLY!
WP80\MyFi1es \Check Request
BUSINESS SERVICES CONNECTION, INC.
260 Riverside Drive, Palm Beach Gardens, FL 33410
561- 694 -7963
Fax: 561 - 694 -1591
February 26, 2010
Invoice No. 10 -21
TO: General Employees' Pension
INVOICE
Office work for week ended February 19, 2010 ....................3.75 hrs
Office work for week ended February 26, 2010 ......................3.75 hrs
7.50 hours @ $35.68
Total Due .................................... ............................... $267.60
Please make check payable to:
Business Services Connection, Inc.
260 Riverside Drive
Palm Beach Gardens, FL 33410
1244
VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S
GENERAL EMPLOYEE'S PENSION TRUST FUND
345 TEQUESTA DRIVE
TEQUESTA, FL 33469 1 63-1312/670
DATE -L4
PAY TO THE
ORDER
f
DOLLARS
ANK
250 Tequeft Dr.. Suft 101, Tequest26 FL 33469
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VMLAGE OF T EQ UESTA CHECK REQUEST
Vendor # - T — Date: Return t® Dept.
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Vendor Name: � � „�, � ,ti /l
Address:
Reason for Request: (Please attach appropriate documentation)
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Total
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Requested By: ✓ ✓i�� Approved By:
(Department Head)
Special Instructions:
REQUESTS RECEIVED IN FINANCE BY TUESDAY AT 5000 PM WILL BY
AVAILABLE. FOR DISTRIBUTION BY THE FOLLOWING MONDAY AT NOON.
PLEASE PLAN YOUR REQUES'T'S ACCORDINGLY!
WP80\MyFi1cs \Check Request
BUSINESS SERVICES CONNECTION, INC.
260 Riverside Drive, Palm Beach Gardens, FL 33410
561- 694 -7963
Fax: 561- 694 -1591
March 10, 2010
Invoice No. 10 -24
TO: General Employees' Pension
INVOICE
Office work for week ended March 5, 2010 ......................3.75 hrs
Office work for week ended March 12, 2010 ......................3.75 hrs
7.50 hours @ $35.68
TotalDue ..................................... ............................... $267.60
Please make check payable to:
Business Services Connection, Inc.
260 Riverside Drive
Palm Beach Gardens, FL 33410
'-.� -„ - -- - -- 1247 �
VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S
GENERAL EMPLOYEE'S PENSION TRUST FUND
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345 TEQUESTA DRIVE
TEQUESTA, FL 33469 ]./�, 63- 1312/670
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VILLAGE O F 1EQ UESTA CHECK REQUEST
Vendor # IDate: Return to Dept.
Vendor Narne: zL.�ra
Address:
Reason for Request: (Please attach appropriate documentation)
A
Charge to Account No. 'Amount:
Total
Requested ��: dZZ Approved By:
(Department Head)
Special Instructions:
REQUESTS RECEIVED IN FINANCE BY TUESDAY AT 5°00 PM WILL BY
AVAILABLE. FOR DISTRIBUTION BY THE FOLLOWING MONDAY AT NOON.
PLEASE PLAID YOUR REQUESTS ACCORDINGLY!
WHOWIyFiles \Check Request
BUSINESS SERVICES CONNECTION, INC.
260 Riverside Drive, Palm Beach Gardens, FL 33410
561- 694 -7963
Fax: 561 - 694 -1591
March 26, 2010
Invoice No. 10 -30
TO: General Employees' Pension
INVOICE
Office work for week ended March 19, 2010 ......................3.75 hrs
Office work for week ended March 26, 2010 ........................3.75 hrs -
7.50 hours @ $35.68
TotalDue ..................................... ............................... $267.60
Please make check payable to:
Business Services Connection, Inc.
260 Riverside Drive
Palm Beach Gardens, FL 33410
n -j-
1248
VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S
GENERAL EMPLOYEE'S PENSION TRUST FUND
345 TEQUESTA DRIVE
TEQUESTA, FL 33469 .1 63-13121670
DATE
A l i PAY TO THE
ORDER OF A r -C s
DOLLARS
L I -XrtN�
A SUNAMERicAN BANK
250 Toqueeft Dr, Sure 101, Taquute6 FL 33469
FOR
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BUSINESS SERVICES CONNECTION, INC.
260 Riverside Drive, Palm Beach Gardens, FL 33410
561 - 694 -7963
Fax: 561- 694 -1591
April 9, 2010
Invoice No. 10 -34
TO: General Employees' Pension
INVOICE
Office work for week ended April 2, 2010 ......................3.75 hrs
Office work for week ended April 9, 2010 ........................3.75 hrs
7.50 hours @ $35.68
TotalDue ..................................... ............................... $267.
Please make check payable to:
Business Services Connection, Inc.
260 Riverside Drive
Palm Beach Gardens, FL 33410
VILLAGE O F TEQUES` A CHECK RE
Vendor # I ?ate:, 1Viai1 Return to Dept.
Vendor Name:
r
Address: i ( 1t� r
Reason for Request: (Please attach appro raate documentation)
Charge to Account No. 669,66.0. 53� 3 a 'Amount: _ -- _ --
Total
Requested By:- Approved By:
(Department Head)
Special Instructions:
REQUESTS' RECEIVED IN, FINANCE BY TUESDAY AT 5:00 PM "WILL BY
AVAILABLE. FOR ]DISTRIBUTION BY THE FOLLOWING MONDAY AT NO
PLEASE PLAN YOUR REQUES'T' ACCORDINGLY!
WP80\MyFi1es \Check Request .
BUSINESS SERVICES CONNECTION, INC.
260 Riverside Drive, Palm Beach Gardens, FL 33410
561 - 694 -7963
Fax: 561- 694 -1591
February 23, 2010
Invoice No. 10 -18
TO: General Employees' Pension
INVOICE
Attend Regular Quarterly Meeting on 2/01/10 and prepare minutes
and synopsis.
(Attendance at meeting 4 -3/4 hours; preparation of minutes & synopsis 8 -3/4 hours)
13-1/2 hours @ $35.68
TotalDue ..................................... ............................... $481.68
Please make check payable to:
Business Services Connection, Inc.
260 Riverside Drive
Palm Beach Gardens, FL 33410
VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S 1245
GENERAL EMPLOYEE'S PENSION TRUST FUND
345 TEQUESTA DRIVE
TEQUESTA, FL 33469
63-1312V670
DATE
PAY TO THE
ORD OF Z- LL �
DOLLARS
T BA
250 ToWests Dr., Sufte 101, T-eq FL 33469
F 0 RAAe
118,00 1 1:0 G 70 13 L 2 4l: 0000008 38 311
VILLAGE DE 1EOUESTA CHECK _QUEST
Vendor # Date: Mail Return to Dept.
Vendor Flame: ���t, � `�- �1 ,�� �.�e c
J
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Address: - '`� ,� r� w - d C
Reason for bequest: (Please attach appropriate documentation)
Charge to Account No. 66a 0 'Amount:
Total , 7 C1
Requested By: _ G Approved By:
(Department Head)
Special instructions:
REQUESTS RECEIVED IN FINANCE BY TUESDAY AT 5 :00 PM WIL BY
AVAILABLE FOR DISTI<tIBI7TION BY THE FOLLOWING MONDAY AT NOON.
PLEASE PLAN YOUR REQUESTS ACCORUINGUY!
WF80\MyFi1es \Check Request
THE LAW OFFICES OF
PERRY & JENSEN, LLC
ANN H. PERRY BONNI SPATARA JENSEN
aperry@perryjensenlaw.com bsjensen @perryjensenlaw.com
February 22, 2010
Via Email
Village of Tequesta
General Employees Pension Fund
Lori McWilliams, Pension Coordinator
345 Tequesta Drive
Tequesta, FL 33469
Re: Legal Services Provided Invoice #63566
Dear Lori:
Enclosed please find the Firm's invoice for services rendered for the
period that ended 2/15/2010. Thank you for your payment of $257.75. Your
current balance due is $2,679.30.
If you have any questions, please do not hesitate to contact me.
Sincerely,
r
Bonni S. Jensen
BSJ /adt
Enclosure
Copy to: Michael Rhodes, Chairman Via Email Only
400 EXECUTIVE CENTER DRIVE, SUITE 207- WEST PALM BEACH, FLORIDA 33401 -2922
PH: 561.686.6550 :• FX: 561.686.2802
13
l'a blolm
'HE LAW OFFICES OF PERRY & JENSEN, LLC
00 Executive Center Drive
suite 207
Vest Palm Beach, FL 33401 -2922
ivoice submitted to:
equesta General Employees Pension Fund
on McWilliams, Pension Coordinator - Via
:mail
45 Tequesta Drive
equesta FL 33469
,opy to: Betty Laur / Michael Rhodes,
;hair -Via Email
ebruary 19, 2010
i Reference To: For professional services rendered as follows:
Client / File No.: 1012
ivoice #63566
Professional Services
Hrs /Rate Amount
Administrator
2/2/2010 ADT Review 0.25 18.75
Review files for scope of work of administrators to provide to Lori 75.00 /hr
McWilliams
Administrator
BSJ Review 0.05 10.00
Review Scope of work Documents 200.00 /hr
Administrator
SUBTOTAL: [ 0.30 28.75]
Attendance at Trustee Meetings
1/27/2010 ADT Prep Atty Rept 1.00 75.00
Prepare Attorney Report, Handouts, and Folder for upcoming Meeting 75.00 /hr
-2/11/10
Attendance at Trustee Meetings
2/1/2010 BSJ Attend 4.50 900.00
Attend meeting 200.00 /hr
Attendance at Trustee Meetings
SUBTOTAL: [ 5.50 975.00]
equesta General Employees Pension Fund Page 2
Hrs /Rate Amount
Forms
1/27/2010 ADT Reformat 0.30 NO CHARGE
Reformat forms for distribution to Harding 75.00 /hr
Forms
ADT Draft 0.50 NO CHARGE
Draft Designation of Beneficiary Form 75.00 /hr
Forms
SUBTOTAL: [ 0.80 0.00]
Misc Matters
1/26/2010 BSJ Draft 0.25 50.00
Draft Memorandum to Board of Trustees 200.00 /hr
Review Attorney General Opinion (AGO) 2009 -56
Misc Matters
1/28/2010 BSJ Draft 1.50 300.00
Draft Presentation re: Sunshine, Public Records, and Ethics Law 200.00 /hr
Misc Matters
SUBTOTAL: [ 1.75 350.00]
Participant - Harding, Catherine
1/27/2010 BSJ Review 0.10 NO CHARGE
Review emails from and respond to Frank Harding 200.00 /hr
E -mail to Lori McWilliams
Participant - Harding, Catherine
BSJ Review 0.75 NO CHARGE
Review email from Michael Rhodes 200.00 /hr
Review emails from Lori McWilliams
Review application and process
E -mail to Frank Harding with applications
Participant - Harding, Catherine
2/3/2010 KS Draft 1.40 NO CHARGE
Draft cover letter to Lori McWilliams for original Documents provided 25.00 /hr
E -mail to Jody Forsythe application and authorization form
Redact personal information from application
Shipped original Documents to Lori at the Village
Participant - Harding, Catherine
SUBTOTAL: [ 2.25 0.00]
For professional services rendered 10.60 $1,353.75
squesta General Employees Pension Fund Page 3
Additional Charges
Qty /Price Amount
Bill File
2/3/2010 PJ UPS Delivery 1 8.08
United Parcel Service Invoice No.: OOOF49280060 8.08
Tracking #1 ZF492804291273695
to / from Lori McWilliams (Harding Application)
Bill File
PJ UPS Delivery 1 6.30
United Parcel Service Invoice No.: OOOF49280060 6.30
Pick up fees
Bill File
2/15/2010 PJ Photocopies$ 1121 280.25
Copy Charges 0.25
Bill File
SUBTOTAL: [ 294.63]
Total additional charges $294.63
Total amount of this bill $1,648.38
Previous balance $1,288.67
Total payments ($257.75)
Balance due $2,679.30
"
`
'
VILLAGE OF TEQUESTA BOARD OF TRUSTEE'S
GENERAL EMPLOYEE'S PENSION TRUST FUND
345 TEQUESTA DRIVE
TEQUESTA, FL 33469 DATE 63-1312/670
PAYTO THE
ORDER OF-
DOLLARS
ASUNAMERicANBA
250 Dr., Suft lot, Tequwbk FL 33M
Tewesw
118 00 L 2LC311 1 :0 C3 ?OL3L241: 00000&R3133
`
THE LAW OFFICES OF
PERRY & JENSEN. LLC
ANN H. PERRY BONNI SPATARA J ENSEN
aperry@perryjensenlaw.com bsjensen @perryjensenlaw.com
January 25, 2010
Via Email
Village of Tequesta
General Employees Pension Fund
Lori McWilliams, Pension Coordinator
345 Tequesta Drive
Tequesta, FL 33469
Re: Legal Services Provided Invoice #63517
Dear Lori:
Enclosed please find the Firm's invoice for services rendered for the
period that ended 1/15/2010. Your current balance due is $1,288.67.
If you have any questions, please do not hesitate to contact me.
Sincerely,
Bonni S. Jensen
BSJ /adt
Enclosure
Copy to: Michael Rhodes, Chairman Via Email Only
400 EXECUTIVE CENTER DRIVE, SUITE 207e. WEST PALM BEACH F LORIDA 33401 -2922
PH: 561.686.6550 •: FX: 561.686.2802
13
Ct¢finL4lblf�lon
THE LAW OFFICES OF PERRY & JENSEN, LLC
400 Executive Center Drive
Suite 207
West Palm Beach, FL 33401 -2922
Invoice submitted to:
Tequesta General Employees Pension Fund
Lori McWilliams, Pension Coordinator - Via
Email
345 Tequesta Drive
Tequesta FL 33469
Copy to: Betty Laur / Michael Rhodes, Chair
- Via Email
January 25, 2010
In Reference To: For professional services rendered as follows:
Client / File No.: 1012
Invoice #63517
Professional Services
Hrs /Rate Amount
IRS Determination Letter
12/16/2009 BSJ Correspondence with 0.25 50.00
Correspondence with Internal Revenue Service to request Extension of 200.00 /hr
Time to reply
IRS Determination Letter
12/18/2009 KA Draft 0.50 NO CHARGE
Draft letter to Internal Revenue Service correcting January 2009 to 75.00 /hr
January 2010
IRS Determination Letter
1/13/2010 BSJ Review 2.00 400.00
Review Request from Internal Revenue Service 200.00 /hr
Review and revise Proposed Plan Documents for GUST and EGTRRA
E -mail to Margaret Saito
IRS Determination Letter
ADT Review 0.45 33.75
Review, Prepare and ship packet to Internal Revenue Service in 75.00 /hr
response to request of 12/10/09
IRS Determination Letter
SUBTOTAL: [ 3.20 483.75]
Tequesta General Employees Pension Fund Page 2
Hrs /Rate Amount
Investment Policy Guidelines
12/21/2009 BSJ Review 0.10 20.00
Review Scrutinized company letters 200.00 /hr
E -mail to Troy Brown for Bogdahn Consulting
Investment Policy Guidelines
SUBTOTAL: [ 0.10 20.00]
Misc Matters
12/18/2009 ADT E -Mail 0.10 7.50
E -mail Internal Revenue Service Mileage Memo 75.00 /hr
Misc Matters
BSJ Draft 0.10 20.00
Draft 2010 Internal Revenue Service Mileage Memo 200.00 /hr
Misc Matters
SUBTOTAL: [ 0.20 27.501
Participant - Harding Catherine
12/16/2009 BSJ Review 0.50 100.00
Review letter from Frank Harding with attachments 200.00 /hr
Telephone call with Frank Harding
E -mail to Lori McWilliams
Participant - Harding, Catherine
12/1812009 BSJ Telephone Call 0.75 150.00
Telephone call with Rion Broshears 200.00 /hr
Review Pension Plan Document and Summary Plan Description
E -mail to Frank Harding
Participant - Harding, Catherine
SUBTOTAL: [ 1.25 250.00]
Special Tax Notice
12/21/2009 BSJ Review and Revise 0.25 50.00
Review and revise Special Tax Notice 200.00 /hr
Special Tax Notice
12/23/2009 ADT Review and Revise 0.25 18.75
Review and revise Special Tax Notice from attorney markup 75.00 /hr
E -mail to administrator
Special Tax Notice
Tequesta General Employees Pension Fund Page 3
Hrs /Rate Amount
SUBTOTAL: [ 0.50 68.75]
For professional services rendered 5.25 $850.00
Additional Charges
Qtv /Price
Bill File
1/13/2010 PJ UPS Delivery 1 26.38
United Parcel Service Invoice No.: OOOF49280030 26.38
Tracking #1 ZF4928002599075499
to / from Margaret Saito, Internal Revenue Service
Bill File
PJ UPS Delivery 1 2.10
United Parcel Service Invoice No.: OOOF49280030 2.10
Pick up request - split with other Fund(s)
Bill File
1/15/2010 PJ Fax$ 2 1.00
Fax Charges 0.50
Bill File
PJ Postage 1 0.44
Postage 0.44
Bill File
PJ Photocopies$ 604 151.00
Copy Charges 015
Bill File
SUBTOTAL: { 180.92]
Total additional charges $180.92
Total amount of this bill $1,030.92
Previous balance $257.75
Balance due $1,288.67
VILLAGE OF TEQ UESTA CHECK REQUEST
V endor # Date: ! Mail Return to Dept.
Vendor Name:
11 tJ
Address:
Reason for Request: (Please attach appropriate documentation
Charge to Account lido. L , Q b' a Ab 17, 0 e 'Amount:
Total 7
_
Requested By: `°:'� $- �` `�. Approved By: '
57 (Department Head)
Special Instructions:
REQUESTS RECEIVED IN FINANCE BY TUESDAY AT 5°00 PM WILL BY
AVAILABLE. F OR DISTRIBUTION BY THE FOLLOWING MONDAY AT NOON.
PLEASE PLAN YOUR REQUESTS ACCORDINGLY!
WP80\MyFiles \Chcck Request
kN ...
invoice Number Invoice Date Account Number Page
7 -022 -99248 Mar 16, 2010 2124 - 4477 -4 1 of
FedEx TaxID: 71- 0427007
Billing Address: Shipping Address:
THE VILLAG E OF TEQUESTA VI LLAGE OF TEQUESTA, THE
345 TEQUESTA DR 345 TEQUESTA DR Invoice Questions?
TEQUESTA FL 33469 -3062 TEQUESTA FL 33469 -3062 Contact FedEx Revenue Services
Phone: (800) 622 -1147 M -Sa 7 -6 (CST)
Fax: (800) 548 -3020
Invoice Summary Mar 16, 2010 Internet: www.fedex.com
FedEx Express Services
Transportation Charges 17.00
Base Discount -3.57
Special Handling Charges 5.31
Total Charges USD $18.74
TOTAL THIS INVOICE USD $18.74
You saved $3.57 in discounts this period!
Other discounts may apply.
A z5 S`
- - - - -- ---- - - - - -- -------------------------------------------------- ...-------------------------- --------------------- --- - - - - -- - --- - --- - - - - - - - - - -- ---- - - - - -- - -
Toensurepropercredit, please return this porfion with your payment toFedE x. Invoice Number Account Number Amount Due
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❑ For change of address, check here and complete form on reverse side. 7 2124- 4477 -4 USD $18.74
Remittance Advice
Your payment is due by Mar 31, 2010
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345 TEQUESTA DR P.O. Box 660481
TEQUESTAFL 33469 -3062
DALLAS TX 75266 -0481
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Invoice Number Invoice Date Account Number Page
7- 022 -99248 Mar 16, 2010 2124 - 4477 -4 4of4
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Distance Based Pricing, Zone 2
Automation USAB Sender Recipien
Tracking ID 865151662800 LORI MCWILLIAMS MS BONNI JENSEN
Service Type FedEx Priority Overnight VILLAGE OF TEQUESTA, THE PERRY & JENSEN PA
Package Type FedEx Envelope 345 TEQUESTA DR 400 EXECUTOVE CENTER DR 207
Zone 02 TEQUESTA FL 33469 -3062 US WEST PALM BEACH FL 33401 US
Packages 1
Rated Weight N/A Transportation Charge 17.00
Delivered Mar 09, 2010 08:54 Fuel Surcharge 1.31
Svc Area A2 - Courier Pickup Charge 4.00
Signed by K.SEIFEL Discount -3.57
FedEx Use 006709460/0000186 / Total Charge USD $18.74
Shipper Subtotal USD $18.74
Total FedEx Express USD $18.74
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f From veasePw.dpm hero. 4a Express Package Service Packages up to r59 lbs.
Senders FedEx 2 1 . FedEx Priority Overnight FedEx Standard Overnight FedEx First Overnight
Date Account Number Nn n bus ness morning. "Friday Nan business afternoon.* ❑ EarGeat next business mommg
shipments will he delivered an Monday - Saturday Delivery NOT available. delivery to -act locedons*
unless SATURDAY Delivery is selected. Saturday Daiivery NOT evaimhle.
Senders FedEx2Da FedEx Ex ress Saver
Name ' r B) Phone ( 5 4u : s. 75-6200 ❑ 5acond busmasa day "Thu sday ❑ Thrd bus nea day.`
shipments will be delivered on Monday Saturday Delivery NDT available.
mess SATURDAY Delivery is selected.
-- Fed &Envekpe rete nor available. Minimum charge: One -pound rate. To most Wed..
Company V 1LLAG E 03 TEGUEFST A THE 4b Express freight Service Packages over Mlbs.
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❑ Nan business de y.— day ❑ Second business dpy. Thursday ❑ Thine,cri ass day."`
f. ¢ . x,t P =+`r% w •�„ U A y-.ay shipment will be delivered on Monday shipmeNb daliveradon Monde, Saturday Delivery NOT available.
Address �?4 t F t unless SATURDAY Delivery is selected. unless SATURDAY Delivery is selected.
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* Call for Confirmation: ""To most b acalli n6 O - -
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5 Packaging
City - • - State F L ZIP 3 44 64 -23 _ LE2.FedEx ❑ FedEx Pak* ❑ FedEx ❑ FedEx ❑ Other
Envelope" IndpdasFedE%SmallPek, Box Tube
2 Your Internal Billing Reference FaEx Large Pak, and FedEx Sturdy P e!:.
Declared value limb $00.
First 24 characters will appear on invoice 6 Special Handling
3 T SATURDAY Delivery HOLD Weekday HOLD Saturday
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Does this shipment contain dangerous goads?
Company I r - ❑ No ❑ El Yes ❑ Dry Ice
As par attach d Shippers Declaration Ory ice, 9, UN 1945 —x —kg
Shippers Declaration not eques
Dang goods (including dry ical cannot be shipped at FedEx packaging. Cargo Aircraft Only
Recipient's
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Address 1 �` �_ -` 7 - Payment Bill to
Enter FedEx Aces NO. or Credit Card No. helow.
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Sender ❑Recipient ❑Third Party E] Credit Card ❑ Cash/Check
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Address will be billed.
To request a package be held at a spec Ric FedEx location, prim FedEx address here. Fed &Acct No. Erp.
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Credit Cord No Dale
City ,' •� State 21P _ Total Pac ges T#MI (E ht Total DecleredValuet
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1 8 Residential Delivery Signature Options Ifyou requires signature, check Director Indirect
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Rev. Data 10109•P-1159279 -01994 -2009 F.H. - PRINTED IN U,S.A -SRS
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