Okaloosa County BOCC — October 21, 2014 — TOMMY MATTONIES Lease/Coordination

CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number:_L/ 3--0395~ BCo Tracking Number: (J 4 2 “LY Grant Funded: YES. NO. Contractor/Lessee Name [Pern Datteriz! __ - Purpose +a Date/Term:__/) | { [ne jo]3ihis 1. LI creater THAN $50,000 amount | ¢59,89 2. L] GREATER THAN $25,000 Department: Pu (e 3. vy $25,000 OR LESS Dept. Monitor Name: Fedele | Kibble Document has been reviewed and includes any attachments or exhibits. Purchasing Review Procurement réquiremen peo ‘4 ZB <> (Wf, Date: ZO -/3 cad asing Director or Designee Joanne Kublik Risk Management Review Approved as written: SK Date: JO-WH4-14} Risk Manager or designee aa.) Kay Godwin or Krystal King County Attorney Review Approved as written: Date: County Attorney Gregory T. Stewart or Lynn Hoshihara Following Okaloosa County approval: Contracts & Grants Document has been received: Date: Contracts & Grants Manager CONTRACT/LEASE RENEWAL FORM Date: August 4, 2014 Tommy Mattonie’s PoBoys & Floribbean Tacos, LLC 723 Eglin Parkway, NE Fort Walton Beach, FL. 32547 RE: Okaloosa County Lease No. L12-0395-BCC Dear Mr. Garner: The Okaloosa County Board of County Commissioners agrees to renew the subject contract/lease, # L12-0395-BCC for an additional term. The lease renewal period will be November 1, 2014 to October 31, 2015. The annual amount for this is $1,859.89. 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 —*s s - -Poogs 7 Dept. Director, J | A Contractor: Vihibsse | Mather 184 : fe Theqs Signature: (06 Ri Ft0ti bow FiOS L LaF Approved By: Charles K. Windes, Jr. Chairman Zan Fedorak, Purchasing Manager ee Approved By: [Om RK Y Approved By: Title: Quer aa (as prescribed below on item 1) A). ‘ Date: Date: 10 L3 ed 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 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.