Okaloosa County BOCC — September 2, 2014 — Task order approval form C12-2007-TDC - 150 — reading text

30062 Vendor's T a vere No.: 770-977-3225 Point of Contact: Rick Gower Sole me : ification: Only available through Southeast Tourism Society partnership; print, online, es dia.co “CEE. lead gengration program. Eb val 08/01/2014 iy Wa SI Requesting mera ent AZ Signature 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 Manager Comments: Purchasing Services Manager Signature Date PURCHASING MANUAL - SINGLE SOURCE DETERMINATION Comments: Approve: GE Disapprove: C4 Amount of Purchase: Date: Ma dlr. Gf. 22114 Purchas} lagi Director Signature Revised — 11/09/98, 03/21/00, 09/18/01, 03/19/02, 09/07/04, 05/15/07, 09/04/07, 09/03/08, 09/12/2011 Aug 13 14 02:54p Gower 7109773225 p.4 CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, all bidders/proposers, must disciose if any Okaloosa Board of County Commissioner, employees), elected officials(s}, or if any of its agencies Is also an owner, corporate officer, agency, employee, ets., of thelr business. Indicate elther "yes" (o county employee. elected official, or agency Is also ossociated with your business). or “no”. If yes, give person(s) name{s) and position(s) with your business. YES, —_——— NOR een NAME(S) POSITION(S) FIRM NAME: Alpha Wolf Media Grou: agent for Southeast Tours! Soclety. BY {PRINTED}: Richard L. Gower. Za. (7 BY (SIGNATURE): TITLE: President DATE: August 9, 2014 ADDRESS: 685 Belleqrove Ridge. Marietta, Georgia 30062, PHONE NO. 770-977-3225 EMAIL Rick@rickqower.com file:////pmafs.pmaady.com/...MA Shared/OKAT/!2014-2015 Media/Conflict of Interest Forms/Escape to the Southeast/non compete PAM. gif[8/14/2014 12:16:44 PM] SINGLE SOURCE PURCHASE DATA SHEET Date: 98/01/2014 PR No.: Requestor: Peter Mayer Phone No, 504.581.7191 Department/Division: Tourist Development Department (TDD) Item Description: 2014/2015 Media Plan TO#150 Requesting Department's Suggested Vendor: Birmingham Weddings & Celebrations Vendor's Addyess: 1731 ist Avenue North, Birmingham, AL, 35203 Vendor's Telephone No.; 205-325-3185 Point of Contact: Haley Isbell Sole Source Justification: Top wedding publication in this primary feeder market; weddings are a target group in the 2014/2015 Strategic Marketing Plan adopted by TDC and BCC. ' hil oso12014 § (27 Lo Requesting Department Head 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 Manager Comments: Purchasing Services Manager Signature Date PURCHASING MANUAL - SINGLE SOURCE DETERMINATION Comments: Approve: a Disapprove: Amount of Purchase: Date: ha seulranl BlzzNp Purchasing Director Signature ateh/ Revised — 11/09/98, 03/21/00, 09/18/01, 03/19/02, 09/07/04, 05/15/07, 09/04/07, 09/03/08, 09/12/2011 19 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 eliher "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. YES | NO ~ NAME(S8) POSITION(S) FIRM NAME: BY (PRINTED): Y (SIGNATURE): TITLE: DATE: ADDRESS: 133! Ist Que North ‘Birmingham, Clq 35203 PHONE NO. (205)32¢- 318 S E-MAIL hisbell @ OL. Cone, SINGLE SOURCE PURCHASE DATA SHEET Date: 8/01/2014 PR No.: Requestor: Peter Mayer Phone No.,: 504.581.7191 Department/Division: Tourist Development Department (TDD) Item Description: 2014/2015 Media Plan TO#150 Requesting Department's Suggested Vendor: NW Florida Bridal Program (Rowland Publishing) Vendor's Address: 1932 Miccosukee Road, Tallahassee, FL, 32308 Vendor's Telephone No.: 850-878-0554 Point of Contact: McKenzie Burleigh Sole Source Justification: Reaches brides in Atlanta and Birmingham - two primary markets for destination weddings dn the Ernerald coast - in ae to NW Florida brides; magazine hosts bridal shows. OC hut 08/01/2014 hi o_// Sf / : Requesting Sepatinont ice Head aos 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 Manager Comments: Purchasing Services Manager Signature Date PURCHASING MANUAL - SINGLE SOURCE DETERMINATION Comments: Approve: ad Disapprove: Amount of Purchase: Date: Gf2z/14 aging Director Signature pate Revised — 11/09/98, 03/21/00, 09/18/01, 03/19/02, 09/07/04, 05/15/07, 09/04/07, 09/03/08, 09/12/2011 19 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. YES NO y s NAME(S) POSITION(S) FIRM NAME; Fete Leb ls /429 C= BY (PRINTED): PYCLANM Katt. AYLI BY (SIGNATURE): APEEELE TITLE: LHES27 DATE: EAB LS ADDRESS: [GBZ- NI AOA2SP-K Ge Od ALCAN Assee Ff 32308 PHONE NO. CSO E16 OSS E-MAIL PRou? Led a BELL satel pvb Oshig , £20 SINGLE SOURCE PURCHASE DATA SHEET Date: 8/01/2014 PR No.: Requestor: Peter Mayer Phone No, 504.581.7191 Department/Division: Tourist Development Department (TDD) ltem Description: 2014/2015 Media Plan TO#150 Requesting Department's Suggested Vendor: Comprint Publications (DC Military Life) Vendor's Address: 9030 Comprint Court, Gaithersburg, MD, 20877 Vendor's Telephone No.: 301-921-2800 Point of Contact: John Rives Sole Source Justification: Over 1/3 of all officers live in D.C., an emerging secondary target market; military family\travel is a target in the 2014/2015 Strategic Marketing Plan adopted by TDC and BCC. Lf y 08/01/2014 "W/L //y Requesting open Head Signature Bate’ 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 Manager Comments: Purchasing Services Manager Signature Date PURCHASING MANUAL - SINGLE SOURCE DETERMINATION Comments: Approve: 4 Disapprove: Amount of Purchase: Date: Qn Solonak Hz f Purchasiig Director Signature Dat Revised — 11/09/98, 03/21/00, 09/18/01, 03/19/02, 09/07/04, 05/15/07, 09/04/07, 09/03/08, 09/12/2011 CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, all bidders/praposers, 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, eic., of their business. Indicate either “yes” {a county employee, elected official, or agency is also associated with your business), or “no”. lf yes, give person(s) narne(s) and position(s) with your business. a YES NO NAME(S) POSITION(S) FIRM NAME: COMPRINT MILITERY PUBUOTINS BY (PRINTED): OHV R\ves BY (SIGNATURE): EBS ; TITLE: PYBUTEL | DATE: P-)RALA ADDRESS: 9030 CONFI CONCT FQ MA SBUIG (MD 26877 PHONE NO. Fl © PO 2696 E-MAIL OLIVES @ C4 2ZETTE VET SINGLE SOURCE PURCHASE DATA SHEET Date: 8/01/2014 PR No.: Requestor: Peter Mayer Phone No,; 504.581.7191 Department/Division: Tourist Development Department (TDD) Item Description: 2014/2015 Media Plan TO#150 Requesting Department's Suggested Vendor: The Griffon (Knight Communications) Vendor's Address: 10150 Mallard Creek Road, Suite 201, Charlotte, NC, 28262 Vendor's nee No.; 866-761-1247 Point of Contact: Bob Boardman Sole Source Justification: Delivered directly to the homes of 108th Training Command members; the 108th,has 10K+ units stationed in the iy ong of the largest authorized plo. theArmy. C7 NK So 08/01/2014 VHZ2 S/S Requesting Dep¢ riment Head Signature Datel 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 Manager Comments: Purchasing Services Manager Signature Date PURCHASING MANUAL - SINGLE SOURCE DETERMINATION Comments: Approve: RIO Disapprove: S) Amount of Purchase: Date: Yuirtidmak o/224i¢ Purcftas) g Diréctor Signature Date / Revised ~ 11/09/98, 03/21/00, 09/18/01, 03/19/02, 09/07/04, 05/15/07, 09/04/07, 09/03/08, 09/12/2011 CONFLICT OF INTEREST DISCLOSURE FORM For purposes ‘of determining any. possible conflict of ifitefest, all biddérs/proposers, must disclose Tal d ity Commissionen-employee(s),- elected. officials(s),..or if any-of Its ogericias 1 1s. also Gri Lowtier, cork ores officer, agency: etriployes, etc.,of their business: indicate either “yes” (a county employee; electéd official, ot agéncy |s also associated with your business}, or rio". If yes, give Betson(s} name(s) and pasition(s)-with your business. YES. . NO x NAME(S) POSITION(S) Knight Coniimunicatioris. DBA-The Griffon FIRM NAME: ; ‘Robert ad Boardman ir RAYA BY (PRINTED): BY (SIGNATURE): TITLE: Resource. Géord linator. BATE: - OG- 1D. ADDRESS: 107150 Malidtd Creek Rodd = Slt 201 _ , , a PHONE NO.. E-MAIL. SINGLE SOURCE PURCHASE DATA SHEET Date: 8/01/2014 PR No.: Requestor: Peter Mayer Phone No.; 504.581.7191 Department/Division: Tourist Development Department (TDD) Item Description: 2014/2015 Media Plan TO#150 Requesting Department's Suggested Vendor: Sports Destination Management (Due North Media) Vendor's Address: 105 Owens Parkway, Suite C, Birmingham, AL, 35244 Vendor's Telephone No.: 800-899-2676 Point of Contact: Gary Andrich Sole Source Justification: Highest circulation publication within sports category; reaches sports event managers a Ga Ca youth - adult) \ n_ FB EE 08/01/2014 ‘4 LES f—f f a Requesting Department Head 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 Manager Comments: Purchasing Services Manager Signature Date PURCHASING MANUAL - SINGLE SOURCE DETERMINATION Comments: Approve: = Disapprove: D Amount of Purchase: Date: Ya dortl Gizeli¢ PurcKasing Director Signature ! Datd Revised — 11/09/98, 03/21/00, 09/18/01, 03/19/02, 09/07/04, 05/15/07, 09/04/07, 09/03/08, 09/12/2011 19 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. YES NO x : NAME(S) POSITION(S) FIRM NAME: bur Nowra Consver mle we. BY (PRINTED): Seen D. Sour’. BY (SIGNATURE): Kall DS. Keer - TITLE: Res BENT DATE: Sf aj i4 ADDRESS: Log Owang PreRewAt Sume C “Bam, Au S85344