Okaloosa County BOCC — February 3, 2015 — Check List for QBVC 2015 for Best Western

Revised: March 12, 2013 Qualified Beach Vendor Certificate Processing Check List (Beach Chair/Umbrella Rentals) New Applications √ Renewal Date Received: Company Name: Best Western of Ft. Walton Beach Contact Person: John Brato Phone #: (850) 434-7285 Email: gibrato@bellsouth.net NA Application form √ $500 Application fee √ Designated Beach Area Permit NA Upland Property Owners Approval NA QBV Beach Vehicle Permit Vehicle insurance Vehicle registration NA $500 QBV Beach Vehicle Permit fee √ Hold Harmless Agreement √ Statement of Acceptance of Ordinance 13-07 √ Copy of Liability Insurance for $1,000,000 naming BCC as additional insured √ Copy of O.C. Local Business Tax Receipt √ Copy of Workman’s Comp. Insurance policy BCC Approval: _______________________ NOTE: The Best Western Hotel is providing their own beach chair/umbrella rentals on the public beach behind its establishment. No vehicle access to the beach is required.