Okaloosa County BOCC — February 18, 2014 — 2014 Burning Up the Beaches signed application — reading text

County’s Special Event and | Sponsorship Funding criteria and guidelines contained in the Tourist Development Operations | & Procedures Manual. | am submitting this application on behalf of my business/organization’s event or promotion and am aware that this application will be reviewed for final approval. | have completed this application fully and accurately. | understand that all information submitted will be used to determine funding eligibility and | have not misrepresented any information contained herein. 9:13 Signature of Applicant Date of Application Printed Name of Applicant Borning OP the Beaches Pp b How do event participants make reservations at Okaloosa County lodging facilities? How do you obtain follow-up information about room nights actually booked for your event from lodging partners? Approximately, how many out-of-town visitors will come to this event? Out-of-town Visitors Approximately, how many lodging rooms will be booked for this event on peak night? Lodging Rooms On average, how many nights do you project these visitors to remain in town? Nights per visitor How many total room nights do you estimate this event will generate for Okaloosa County? (number of rooms anticipated per night x number of event nights) Upon completing this application in its entirety, please read the following statement and affix your signature accordingly. I have read, fully understand and agree to be bound by Okaloosa County’s Special Event and Sponsorship Funding criteria and guidelines contained in the Tourist Development Operations & Procedures Manual. | am submitting this application on behalf of my business/organization’s event or promotion and am aware that this application will be reviewed for final approval. | have completed this application fully and accurately. | understand that all information submitted will be used to determine funding eligibility and | have not misrepresented any information contained herein. see addithona| application poe for Signatere Signature of Applicant Date of Application Printed Name of Applicant OFFICIAL USE ONLY AMOUNT AWARD #G COCO, = e APPROVED BY: Pad é Ohne DATE: a / af 13 tite of Tourist Development dept. APPROVED BY: DATE: Purchasing Director le CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, all bidders/proposers, must disclose if any Okaloosa Board of County Commissioner, employee(s), elected officials(s), or if any of its agencies is also an owner, corporate officer, agency, employee, etc., of their business. Indicate either “yes” (a county employee, elected official, or agency is also associated with your business), or “no”. If yes, give person(s) name(s) and position(s) with your business. YES, NO. xX NAME(S) POSITION(S) FIRM NAME: Horizons BY (PRINTED): LA Woodall BY (SIGNATURE): TITLE: Director of Community Development DATE: 9-6-2013 ADDRESS: 123 Truxton Av Fort Walton Beach FI 32547 PHONE NO. 850-250-4142 E-MAIL lawoodallhorizons@gmail.com SOLE SOURCE PURCHASE DATA SHEET Date: _9/19/2013 PR No.: Requestor: Tourist Development Phone No.: Department/Division: _Tourist Development Department Item Description: Marketing / Advertising for Burning Up the Beaches 2014 Requesting Department's Suggested Vendor:_Horizons of Okaloosa County Vendor's Address: 123 Truxton Avenue, Fort Walton Beach, FL_32547 Vendor's Telephone No.: 850-259-4142 Point of Contact:_Mr. L.A. Woodall Sole Source Justification: Event specific advertising that only the source vendor can provide. 4li9 | 13 Ddte REVIEW BY PURCHASING DEPARTMENT VERIFY IF OTHER SOURCES OF SUPPLY MEETS THIS NEED Vendor #1 Contact: Phone No.: Vendor #2 Contact: Phone No.: Vendor #3 Contact: Phone No.: Buyer Comments: Signature of Buyer Who Reviewed Date Purchasing Services Coordinator Comments: Purchasing Services Coordinator Signature Date PURCHASING MANUAL - SOLE SOURCE DETERMINATION Comments: Approve: Disapprove: Amount of Purchase: Date: Purchasing Director Signature Date