Okaloosa County BOCC — September 1, 2015 — Public Financial Management Renewal

CONTRACT/LEASE RENEWAL FORM July 27, 2015 Public Financial Management Attn: William B. Case 8200 Bryan Dairy Road, Suite 325 Largo, FL 33777 RE: Contract Renewal Dear Mr. Case: The Okaloosa County Board of County Commissioners agrees to renew the subject contract/lease, # C03-0786-AP for an additional term. The contract renewal period will be 10-01-15 to 09-30-16 . The annual budgeted amount for this contract is $.30,000.00 . All other terms and conditions of the original agreement shall remain in full force and effect through the duration of this renewal. 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). COUNTY REPRESENTATIVES AUTHORIZED COMPANY REPRESENTATIVE Dept. Direcfo%fi Confrgctorf{) /”\P&r\u&J /WWf’ffw/ A<, Signature: Date: Approved By: Z\/L,QO K CJQ Approved By: (as prescribed below onjtem 1) Date: 7/ ‘// » Jo< Approved By: Title: fi/ e V} (as prescribed below on item 1) Date: Date: g//j//'[ County Department Instructions: 1) Obtain signatures from Department Director, authorized Company Representative and then Purchasing Director <$25K and less, County Administrator <S50K 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 Certificate 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: ( ! t ) 3—0780' &t Tracking Number: / 200 ‘lS Grant Funded: YES NO_ )¢ Contractor/Lessee Name: Purpose &flw b Date/Term: 4/ 30/ I 1. ] GREATER THAN $50,000 Amount: d* 30 go0 2. [ L] GREATER THAN $25,000 Department: 3. [] $25,000 OR LESS Dept. Monitor NamM% Document has been reviewed and includes any attachments or exhibits. Purchasing Review K Date: 7"91 ’6 Joanne Kublik or Sunnie Estes Puychasing Dlrctor or D[nee ( / N Risk Management Review Approved as written: C%wm EB1Fn Beie__ e =& Risk I)hanager @signee Laura Porter or Krystal King County Attorney Review Vb Date: 7-1\ {T Gregory T. Stewart or Lynn Hoshihara Following Okaloosa County approval: Contracts & Grants Document has been received: Date: Contracts & Grants Manager