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Okaloosa County BOCC — September 16, 2014 — Destin Seafood Application — reading text
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event-specific advertising that only the event promoter can
provide as an approved applicant under the TDD's Special Event and Sponsorship funding
rogram.
Requesting Department Director Signature Date
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
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.
No
YES. NO.
NAME(S) POSITION(S)
FIRM NAME: Destin Seafood Festival
BY (PRINTED): Jami M Jones
BY (SIGNATURE): Hw ( Uhie—
Festival Chairman
TITLE:
— 9/4/14
ADDRESS: PO Box 103
Destin, FL 32540
FORE NG: 850-428-7783
E-MAIL destindsf@yahoo.com