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NORTHWEST FLORIDA'S EMERALD COAST DESTIN | FT. WALTON BEACH [| OKALOOSA ISLAND Special Event and Sponsorship Expense Reimbursement Request To receive Special Event and Sponsorship Funding reimbursement, please submit the following: 1. Invoice(s) from your organization to Okaloosa County Tourist Development Department for payment of authorized expenditures as described on page 2 of the Funding Application. 2. Substantiating backup per activity or copy of proof of payments such as cleared check record showing front and back of checks, or detailed credit card receipts. For all media buys please provide tear sheets, copies of advertisements, schedules and signed station affidavits. 3. Copies of marketing, advertising and communications materials and/or websites showing Okaloosa County Tourist Development Department logo and links. Festival, Event, Meeting or Convention (“Event”) Information Event Name: Florida State HOG Rally Event Description: Five day Harley Owner Group Rally that brings members from Harley Owner's Groups from all over the US. There is only one of these rallies in each state. Event Dates — From: Oct. 21, 2014 To: Oct. 25, 2014 Event Location (include all locations in Okaloosa County where events occurred): Okaloosa Island & Destin Contact Person: Bruce Fuller / Ken Fox (Treasurer) Title, Rally Coordinator Phone: 352-516-6485 / 386-679-9191 (Ken Fox) Alt Phone: Contact Email: harkone75@aol.com / Ken Fox: zorr59@aol.com Awarded Amount: $ 20,000 Hee one Payable To: (Please Note — Organization must be same organization that applied for unding Florida State Rally, Inc. Tax I.D. or Social Security Number: 65-0727400 BCC approved 3/19/2013 EXPENSES TO BE REIMBURSED Itemized expenses to be reimbursed by the Special Event and Sponsorship funds must be allowable as detailed on page 2 of the Funding Application. Inv expenses only with backup included. oices must be for approved __EXPENSE ITEM __ AMOUNT Direct Mail Postage 403.94 Mail Out Printing 6212.15 Thunder Roads Magazine 800.00 Rebel Rider Magazine 800.00 Total: $8216.09 | certify that the above information is true and accurate to the best of my knowledge. Potten BBL 10/7/2014 Signature , Date Kenneth R Fox Printed Name BCC approved 3/19/2013 Florida State HOG Rally - 2014 Ken Fox - Treasurer 819 E. 11th Ave. New Smyrna Beach, FL 32169 Bill To: Okaloosa County TDC P. O. Box 609 Ft. Walton Beach, FL 32549 Purchase Order # 21401250 Attn: Sherry Rushing INVOICE Date Invoice # 10/1114 300 Description 2014 Florida State HOG Rally Pre-event Marketing and Attendance Stimulation Efforts -Sponsorship Direct Mail Postage Mail out Printing Advertising In Thunder Roads Magazine Advertising In Rebel Rider Magazine 403.94 6212.15) 800 800 $8,216.09 @@ ~~ GAINESVILLE FL 32606-3735 Zone-2 Priority Mail 2-Day By Weight 1 1b. 0.30 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837413 Includes $50 insurance Issue PVI: @@ ~~ ORLANDO FL 32805-6617 Zone-1 Priority Nail 1-Day By Weight 1 1b. 0.50 oz. Expected Delivery: Wed 07/09/14 USPS Tracking #: 9114901230803805837437 Includes $50 insurance Issue PVI: @@ ~~ SARASOTA FL 34232-6300 Zone-2 Priority Mail 2-Day By Weight 1 |b. 0.30 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837451 Includes $50 insurance Issue PVI: @@ ~~ PALM BAY FL 32905-6323 Zone-1 Priority Mail 1-Day By Weight 1 1b. 0.30 oz. Expected Delivery: Wed 07/09/14 USPS Tracking #: 9114901230803805837475 Includes $50 insurance Issue PVI: @@ ~~ WOODSTOCK GA 30188-5955 Zone-4 Priority Mail 2-Day By Weight 8.70 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837499 Includes $50 insurance Issue PVI: @@ “” HIRAM GA 30141-4762 Zone-4 Priority Mail 2-Day By Weight 8.80 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837024 Includes $50 insurance Issue PVI; @@ ~~ DANIELSVILLE GA 30633-4074 Zone-4 Priority Nail 2-Day By Weight 8.70 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837048 Includes $50 insurance Issue PVI; $5.80 $5.80/ $5.80 seecsecs $5.95 / SSS et NEW SMYRNA BEACH MAIN PO new smyrna beach, Florida 321689998 1143840600 -0096 07/08/2014 (800) 275-8777 10:08:30 AM = — Sales Receipt Product Sale Unit Description Qty Price @@ ~* OCALA FL 34478-5005 Zone-2 Priority Mail 2-Day By Weight 1 1b. 0.30 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837291 Includes $50 insurance Issue PVI: @@ ~~ MIAMI FL 33157-7613 Zone-3 Priority Mail 2-Day By Weight 1 lb, 0.30 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837314 Includes $50 insurance Issue PVI: @@ “* FORT LAUDERDALE FL 33325-6218 Zone-3 Priority Mail 2-Day By Weight 1 1b. 0.30 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805937338 Includes $50 insurance Issue PVI; @@ ~~ TIFTON GA 31793-8313 Zone-3 Priority Mail 2-Day By Weight 1 |b. 12.70 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 911490 1230803805837352 Includes $50 insurance Issue PVI: @@ ~~ SAVANNAH GA 31419-9752 Zone-2 Priority Mail 2-Day By Weight 1 lb. 14.20 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837376 Includes $50 insurance Issue PVI; @@ ~~ TAMPA FL 33614-3931 Zone-2 Priority Mail 2-Day By Weight 1 |b. 0.30 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837390 Includes $50 insurance Final Price $5.80 $6.15 $6.15 @@ ~~ CALHOUN GA 30701-7102 $5.85 Zone-4 ; Priority Mail 2-Day By Weight 8.90 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837444 Includes $50 insurance Issue PVI: @@ ~~ EVANS GA 30809-3876 Zone-3 $5.70 Priority Mail 3-Day By Weight 8.70 oz. Expected Delivery: Fri 07/11/14 USPS Tracking #: 9114901230803805837468 Includes $50 insurance Issue PVI: $5.70 7 @@ ~~ LUTZ FL 33549-7207 Zone-2 $5.60 Priority Mai) 2-Day By Weight 8.70 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230603805837482 Includes $50 insurance Issue PVI: $5,607 @@ ~” TUSCUMBIA AL 35674-4438 $5.85 Zone-4 : Priority Mail 3-Day By Weight 8.70 oz. Expected Delivery: Fri 07/11/14 USPS Tracking #: 9114901230803805837505 Includes $50 insurance Issue PVI: $5,857 @@ ~~ SVLACAUGA AL 35150-4884 $5.85 Zone-4 Priority Mail 2-Day By Weight 8.90 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837512 Includes $50 insurance oa Issue PVI: $5.85 @@ ~” SUMMERVILLE SC 29483-2866 $5.70 Zone-3 ; Priority Mail 2-Day By Weight 8.80 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837536 Includes $50 insurance seeseece Issue PVI: $5.70 7 @@ ~~ UNION GROVE AL 35175-9378 $6.85 Zone-4 Priority Mail 2-Day By Weight 1 lb. 2.20 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837321 Includes $50 insurance Issue PVI: $6.85“ G@@ ~~ STUART FL 34997-6664 $5.80 Zone-2 Priority Mail 2-Day By Weight 1 1b. 0.20 oz, Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837345 Includes $50 insurance BecasceH Issue PVI: $5.80~ @@ “” HAMPTON GA 30228-2272 $5.85 Zone-4 Priority Mail 2-Day By Weight 8.70 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837369 Includes $50 insurance Issue PVI: @@ ~~ ORANGE PARK FL 32073-6730 Zone-2 Priority Mail 2-Day By Weight 1 1b, 0.10 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837383 Includes $50 insurance Issue PVI: $5.80-~ @@ ~~ LAKELAND FL 33805-1972 $5.80 Zone-2 Priority Mail 2-Day By Weight 1 Ib. 0.10 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837406 Includes $50 insurance Issue PVI: $5.80” @@ ~~ COLUMBIA SC 29224-3601 $6.85 Zone-4 Priority Mail 2-Day By Weight 1 Ib. 0.10 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837420 Includes $50 insurance Issue PVI: $6.8 @@ ~” MARIETTA GA 30062-2088 Zone-4 Priority Mail 2-Day By Weight 1 lb. 0.10 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837208 Includes $50 insurance Issue PVI: @@ “” TALLAHASSEE FL 32317-4591 Zone-3 Priority Mail 2-Day By Weight 1 1b. 0.20 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837222 Includes $50 insurance Issue PVI: @@ “* FORT MYERS FL 33907-1410 Zone-2 Priority Mail 2-Day By Weight 1 ib. 0.10 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837246 Includes $50 insurance Issue PVI; @@ ~~ FORT MILL SC 29708-8964 Zone-4 Priority Mail 2-Day By Weight 1 1b. 0.20 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837260 Includes $50 insurance Issue PVIs @@ ~~ SAINT SIMONS ISLAND GA 31522-2005 Zone-2 Priority Mail 2-Day By Weight 1 1b, 0.10 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837284 Includes $50 insurance Issue PVI: @@ ~~ AUSTELL GA 30106-1482 Zone-4 Priority Mail 2-Day By Weight 1 1b. 0.10 oz, Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837307 Includes $50 insurance Issue PVIs $6.85 $6. $6.15 $6. ss== 807 85 @@ ~~ WARNER ROBINS GA 31088-5519 Zone-3 Priority Mail 2-Day By Weight 8,70 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837062 Includes $50 insurance Issue PVI: @@ ~~ LEXINGTON SC 29072 Zone-4 Priority Mail 2-Day By Weight 8.70 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837086 Includes $50 insurance Issue PVI: @@ ~* GALIVANTS FERRY SC 29544-9065 Zone-4 Priority Wail 3-Day By Weight 8,70 oz. Expected Delivery: Fri 07/11/14 USPS Tracking #: 9114901230803805837109 Includes $50 insurance Issue PVI: @@ “* NEW PORT RICHEY FL 34652-6023 Zone-2 Priority Mail 2-Day By Weight 1 1b. 0,10 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837123 Includes $50 insurance Issue PVI: @@ “” WEST PALM BEACH FL 33407-1911 Zone-2 Priority Mail 2-Day By Weight 1 1b. 0.20 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837 147 Includes $50 insurance Issue PYI: @@ ~~ TAMPA FL 33619-2615 Zone-2 Priority Mail 2-Day By Weight 1b. 0.10 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837161 Includes $50 insurance Issue PVI: @@ ~” ANDERSON SC 29626-5164 Zone-4 Priority Mail 2-Day By Weight 11.90 oz, Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837185 Includes $50 insurance Issue PVI: OO — Oe eee eee $5.70 ee7 $5.85 $5.85 $5.85 ascssss= $5.80. $5.80 @@ ~” MIAMI FL 33176-4342 Zone-3 $5.70 Priority Mail 2-Day By Weight +20 oz. eae Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837550 Includes $50 insurance Sesese=s ec Issue PVI: $5.70 @@ ~~ FLORENCE SC 29505-5213 $5.85 Zone-4 : Priority Mail 2-Day By Weight 8.80 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837574 Includes $50 insurance REBEL Issue PVI: $5.85 @@ ~~ MONTGOMERY AL 36117-4358 $5.85 Zone-4 Priority Mail 2-Day By Weight 8.80 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837598 Includes $50 insurance Issue PVI: $5.85 @@ ~* ALPHARETTA GA 30022-5552 $5.85 Zone-4 Priority Mail 2-Day By Weight 8.70 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837611 Includes $50 insurance seeesese Issue PVI: $5.85 @@ “” TRAVELERS REST SC $5.85 29690-8173 Zone-4 Priority Mail 2-Day By Weight 8.70 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837635 Includes $50 insurance Issue PVI: @@ ~~ SHALIM, 32579-1202 Zone-4 Priority Mail 2-Day 8.70 oz. Expected Delivery: USPS Tracking # @@ ~~ BOILING SPRINGS SC $5.85 29316-9069 Zone-4 . Priority Mail 2-Day By Weight 8.90 oz. Expected Delivery: Thu 07/10/14 USPS Tracking #: 9114901230803805837673 Includes $50 insurance Issue PVI: $5.B57 @@ “~ MOBILE AL 36618-4480 $5.85 Zone-4 Priority Mail 2-Day By Weight 8.70 oz. Expected Delivery: Thu

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