Okaloosa County BOCC — August 4, 2015 — CHELCO Lease Renewal

CONTRACT/LEASE RENEWAL FORM June 10, 2015 Choctawhatchee Electric Cooperative, Inc. Attention: Steve Wolfrom PO Box 512 Defuniak Springs, FL 32433-0512 RE: Contract/Lease L13-0401-WS Dear Mr. Wolfrom: The Okaloosa County Water & Sewer Department agrees to renew the subject contract/lease, L13-0401-WS for an additional term. The contract renewal period will be September 1, 2015 to August 31, 2016. If you are in agreement, please sign below and return this form along with a current Certificate of Insurance listing Okaloosa County as co-insured (if applicable) to Jeff Littrell Director, Water & Sewer, Okaloosa County Board of Commissioners, 1804 Lewis Turner Boulevard, Suite 300, Fort Walton Beach, FL 32547. COUNTY REPRESENTATIVES AUTHORIZED COMPANY REPRESENTATIVE Dept. Director ™~ L H gg ContractorChoctawhatchee Electric Cooperative, Inc. Signature: «Jm“ W . Approved By: Approved By: 'Q‘j nm / f O (as prescribed below/on item 1) -0 // Approved By: Title:Vice President of Member Services (as prescribed below on item 1) Date: Date: June 29, 2015 County Department Instructions: 1) Obtain signatures from Department Director, authorized Company Representative and then Purchasing Director <$25K and less, County Administrator <$50K and less or Board >$50K, as necessary. If Board approval is required, the Chairman and County Administrator's signatures are required. Make sure the company provides a current Cerlificate of Insurance. (If applicable). 2) Keep a copy of this form for your records. 3) Send original to Purchasing Services Coordinator. If you have any questions please contact the Purchasing Director at 850-689-5960, Fax: 850- 689-5998. CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number: £-) 3 —D?O/ -WS Tracking Number:_/ 27/ 7—/ 5 Grant Funded: YES NO o Contractor/Lessee Name: ( }Lg, (c’."c‘) ). Purpose ,/L'_C ree iz K Date/Term: “ | 3 ) IR 1 D GREATER THAN $50,000 ] Amount: /\/ A 2 D GREATER THAN $25,000 Department: W S 3. Q $25,000 OR LESS Dept. Monitor Name:, ‘i','dl/@('////?) AL LJEN Document has been reviewed and includes any attachments or exhibits. Purchasing Review Rrocurement requnremen are /Z;/ R pate:__ (=25 Purchasmg D}ector or fiemgnee Joanne Kublik or Sunnie Estes Risk Management Review Approved as written: %WM% ’(71\ Date: tO" 115 Risk Manager or designee ) Laura Porter or Krystal King County Attorney Review pproved as wri —— — Date: ('3 -lby— I 13 Cou%y(Ajo\‘ney ' Gregory T. Stewart or Lynn Hoshihara Following Okaloosa County approval: Contracts & Grants Document has been received: Date: Contracts & Grants Manager [;cells