HomeMy WebLinkAboutSprint-Treasurer Safe Transmittal Form.docDOCUMENT SAFEKEEPING REQUEST______________________________________
TO: TREASURER’S OFFICE DATE: March 10, 2014
FROM: Development Services, Lana Adler Contact Phone: 800-357-7641
SUBECT: Transmittal of Document(s) for Safekeeping in the Treasurer’s Vault____________________________________
Please place in the safe of the Treasurer’s Office for safekeeping until release to the above department is authorized.
Document (circle one): Performance Bond / Surety Bond / Bank Deposit / Irrevocable Letter of Credit (Amendment)
Other:
Document Number: 104246106 Project(s)/Permit(s): Sprint Nextel / MUP 01-09
Dollar Amount: _$2,500.00____________ APN: 039-260-018
Document Date: _February 19, 2014________ Property Owner/Principal: Sprint Nextel Property Services (Principal)
Maturity Date: _N/A
Renewal Terms: _N/A___ Purpose: Renewal of Bonds
Non-renewal Notice Period: N/A________ Bank / Surety Company: Travelers Casualty & Surety Comp. America
Authorized for Safekeeping By:
_________________________________________________________ Rowland Hickel, Senior Planner________________ Signature Date Name and Title
Acknowledgement of Receipt by Treasurer’s Office:
__________________________________________
Authorized Signature Date Name and Title
For questions, contact the Treasurer’s Office at 538-7576
Release Authorized By:
_________________________________________________________ ___________________________________________
Signature Date Name and Title
Received By:
_________________________________________________________ ___________________________________________
Signature Date Name and Title
Document(s) attached
cc: Auditor’s Office
File
________________
Instructions: Do not combine different types of documents on one form. Bring original document with this form and sufficient copies for departmental distribution to the Treasurer’s
Office. Retain a copy of the original documents with a copy of this form showing the tracking number assigned by Treasurer’s Office.
Treasurer’s Tracking#
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