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HomeMy WebLinkAboutS_Check_Request_Permit_Cash_Surety_Release_C17005029_180212CheckRequestforNonVendorRefundorReimbursementThisformistobeusedonlyforonetimevendors.PleasecontactAccountsPayablefyouhaveanyquestionsregardingonetimevendors.Checkit’ll!beincludedinthenextscheduledA/Pcheckrunandmailed41crCouncilapprovaLCheckRequestInfo:Dateofrequest:2/12/18Requestor‘5name:Requestor‘sdepartment/division:Requestor‘sext.#:StacyTuckerCED/Planning7282‘Payableto:AlbacoreACH,LLCMailaddressforcheck:9675SE36thStreet;Suite105;MercerIsland,WA98040;Attn:LaurieNyberqCheckamount:Accountnumber(s)tocharge:Amountperaccount#:$12,036.75650.000000.000.237.0O.00.0000$12,036.75Reasonforrefundorreimbursement:Releaseperprojectmanager,RohiniNair.PermitC17005029finaled1/17/18.Checkhandlingrequest:Memo:Permitbondreimbursementpermit#C17005029*ApprovaISignature*rhepersonapprovingthischeckrequestmustbeanauthorizedsigner.Requestor‘sDepartmentAdministrator,DivisionDirectorordesignee:Signature:tAP&flfrfJennferHenningtypenameofsigneronabovelineDate:February12,2018Docunnt3Onlinel3peobleForm,July2001 BILLINGINVOICEEG00084748CITYOF—“RentonC)1055SGradyWay,Renton,WA98057DEPARTMENT:SystemAdministratorTransactionDate:February12,2018AR:EdenInvoice:BILLINGCONTACTMARISSAGOSSAlbacoreACHLLC9675SE36thSt,Suite105MercerIsland,WA98040REFERENCENUMBERFEENAMETRANSACTIONPAYMENTAMOUNTPAIDC17005029ENG-SpecialDepositRefundRefundFinanceAPi,esaaaooaoMoo.237.oaoo.ooo5(12,036.75)5(12036.75)SUBTOTALS(12,036.75)TOTALs(1z,036.75)Notes:CreatedByDateNoteStacyTucker02/12/2018Releaseperprojectmanager,RohiniNair.Permitfinaled1/17/18.PrintedOn:February12,2018PreparedBy:StacyTuckerPage1oil RECEIPTEG00077788BILLINGCONTACTC.—Renton01055SGradyWay,Renton,WA98057TransactionDate:November13,2017MARISSAGOSSAlbacoreACHLLC9675SE36thSt,Suite105MercerIsland,WA98040STRANSACTIONPAYMENTREFERENCENUMBERFEENAMEAMOUNTPAIDTYPEMETHODC17005029ENG-SpecialDepositFeePaymentCheck#2543512,036.75SUBTOTALSi2.036,75TOTAL$12,036.75PrintedOn:February12,2018PreparedBy:DianaHiattPage1of1