Okaloosa County BOCC — September 1, 2015 — First Southwest Renewal

CONTRACT/LEASE RENEWAL FORM Date: 8/6/2015 First Southwest Company Attn: Mark P. Galvin 450 South Orange Avenue, Ste. 460 Orlando, Florida 32801 RE: Contract Renewal Dear Mr. Galvin: The Okaloosa County Board of County Commissioners wishes to renew the subject contfract/lease, #C04-1098-BCC for an additional term. The contract renewal period will be October 1, 2015 to September 30, 2016. If you would like to review the previously accepted contract, please feel free to view on-line at http://www.co.okaloosa.fl.us/contracts/contra_pdf/C04-1098-BCC.pdf If you are in agreement, please sign below and return this form along with a current Cettificate of Insurance listing Okaloosa County as co-insured (if applicable)to County Administrator's Office, 1804 Lewis Turner Blvd., Suite 400, Fort Walton Beach, FL 32547. COUNTY REPRESENTATIVES AUTHORIZED COMPANY REPRESENTATIVE /TO Contractor: I’\fs”v gOLL‘H‘\\)JiS* CON\PW\\‘ \ LLC Approved ;;%&4/0 | sm— / nite: Senior \ice President Dept. Director (o /wamf/fc S Signature: S;,’/? n] 2V DA o, Approved By: (as prescrib below6n item 1) Approved By: (as prescribed below onitem 1) Date: Date: 8‘ lOl > 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. CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number:__ ("0 Y — JOFK K¢ Tracking Number: /‘L/"?({,)E’ = 3 Grant Funded: YES NO k< 1 LI Contractor/Lessee Narr{e: %m{* CL Purpose W_ Date/Term: (/?/'30 ’/ b i I:I GREATER THAN $50,000 7 J Amount: 2. D GREATER THAN $25,000 Department: Q A 3. [ ] $25,000 OR LEsS Dept. Monitor Name: g]’;%.// Document has been reviewed and includes any attachments or exhibits. Purchasing Review Procurement requurements are rrfet /’ / %C;% 8 .//// fl/ Date: ?’;5”/5 Purchasing Director or Des;énee Joanne Kublik or Sunnie Estes Risk Management Review Approved as written: M ()%\y Date: % - 25- Risk lglan%er or desagnee Q Laura Porter or Krystal King County Attorney Review Approved as written: @ E Date: 5 - 3 / @ C/w(ty Attorney Gregory T. Stewart or Lynn Hoshihara Following Okaloosa County approval: Contracts & Grants Document has been received: Date: Contracts & Grants Manager