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