Okaloosa County BOCC — December 16, 2014 — Contract Coord Sheet - TSA Agreement-LEO — reading text

CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number: None Tracking Number: A qy ~49 Contractor/Lessee Name: TSA(Homeland Security) Grant Funded: YES_X__ NO__. Purpose: Law Enforcement Officer Financial Assistance CLOSEOUT Date/Term: N/A 1. EX] GREATER THAN $50,000 Amount: 2. [-] GREATER THAN $25,000 Department: Airports 3. [] $25,000 OR LESS Dept, Monitor Name: Hormen Document has been reviewed and includes any attachments or exhibits. Purchasing Review Date: A/ “oh Gal va Risk Management Review Approved ‘as written: AN to LAK ion, pate: A-A~-|'¢ isk Manager or designe (— County Aliorney Review groved cs oe Ay or C7 1. Lopniy Attorthey N Sa Date: | Ie ~\Y¥ Following Okaloosa County approval: Contracts & Gronis Document has been received: Date: Contracts & Grants Manager 4 AMENDMENT OF SOLICITATION/MODITNICATION OF CONTRACT 1 CONTRACT 1D GODR “a OF _ 2. AMBNDMENTIMODIFIGATION NO, 3, EFFECTIVE DATE 4, REQUISITION/PURCHASH REO, NO, 5. PROIBCT NO. (ff appiteubie) P90008 See Block 16C “6. ISSUED BY 7 ADMINISTRATED BY (if other than lain © Office of Acquisition, TSA-10 Office of Finanolal Management, TSA-16 Transportation Seowlty Administration Office of Security Technology 601 South 12" Street "4-701 South 12" street Arlington, VA 22202-4220 Arlington, VA 22202-4220 i. NAMI AND ADDRESS OF GONTRAGTON (Nos alvoal ooaniyn Mane and IP Coda) [] | 94.” AMENDMENT GF SOLICITATION NO, - Okaloosa County Board of County Commissioners 1804 Lewis Tumer Blvd. #206 Fort Walton Beach, Florida 32547 98, DATED (G82 ITEM {1) BJ toa. MODIFICATION OF CONTRACTIORDER NO, HSTS02-08-H-SLR287 TAR WATTRTY CORE FTAA FN CAGE CODE: FACILITY CODE 10/1/2007 11, ‘THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS i] The above nambered solicitation is smonded as set forth Jn Item 14, Tha hour ant date specified for revelpt of Offer Is [l axtended l | fs not extended, Offers nnist acknowledge receipt of this amencment prior to the hour and date speoifled in the solicitation on as amended, by one of the following methods; (a) By completing Item 8 and 15, ond returning’. __ copies of the amendments (b} soknowledging meeelpt of this amendment on each copy of tho offer submitted; or (oc) By separate lotter or telegram whioh Inolndes a reference to the solfoltution and amendment numbers, FAILURE OF YOUR ACKNOWLEDG. MENT TO BE RECBIVED AT THE PLACE DESIGNATED FOR RECEIPT OF OFRERS PRIOR TO THR HOUR AND DATE SPECIMIED MAY RESULT IN REJBCTION OF YOUR OFFER, If by virtue of this amendment you desire to change an offer alrendy submitied, such change may be made by telegram or lattor, provided exch tolegram or etter makes reference to the solloltation and this amendment, and is rocalved pelor to the opening hours and date specified. * ta ACCOUNTING AND APPROPRIATION DATA (f'raquiecd) ($15,098.40) De-Obligated 43, THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTSYORDIERS PT MODIFIES THE CONTRACT/ORDER NO, ~ _ . a AS DESCRIBED IN TEM 14, _ A. THIS CHANGE ORDER 8 ISSURD PURSUANT TO! Speolfy antianty) THE CHANGES SET FORTH IN ITEM J4 ARE MADE IN THE CONTRACT/ORDER NO, IN ITEM 104A, ri B, THE ABOVE NUMBERED CONTRACTIORDUR 18 MODIMED 10 REFLECT THE ADMINISTRATIVE CHANORS Guah as alanges bu panlag oflce appropriation data, eto) SET PORTH IN ITRM 4, THis SUPPLEMENTAL AGREEMENT 18 ENTERED INTO FURSUANTTO AUTHORITY OF ASL Mu eS th patties, D, OTHER Spsoifp bye af modification and authority) BJ | AMS 3.10.10 Closeout of Completed File, FAR 4,804 and Far Clause 1.6022 Closeout of Contract Files. rie E, IMPORTANT: Contnotor El is not, BJ is required to sige thls document gnd return £ copy to the issuing office, (4, DESCRIPTION OF AMENDMENT/MODINICATION (Organized by UGE section headings, noluding solfetatlon/eanisact subjege matter wire feasible, The purpose of this modification fs to de-obligate residual finds and close the Agreement referenced in Block 10A above in jis entirety. De-obligation of residual funding is referenced in Block 12 above, The funded amount of this Agreement is reduced from $882,262.43 by $15,098.40 to $867,164,02 The Okaloosa County Board of County Commissioners does remise, release, and discharge the Government, its officers, agents and employees, of and from al] liabilities, obligations, claims and demands whatsoever under or arising from the said Agreement, Therefore, this Agreoment is hereby closed, The parties hereby certify that all contract actions required by the contract have been fully and satisfactorily accomplished, HHTHHITEINAL ACTIONAMHHH Except as provided harain, all torms and conditions of the document refershoed Ja Item 9A or 10A, a9 horptoforg changed, comeins unel: 1 and In full force and effoct, ISA. NAME AND TITLE OF SIGNER (Type or print) 164, NAME AND TITLE OF CONTRACTING OFFICER (ype or prial Charles K, Windes, Jr., Chairman Mark Lane Okaloosa County Board of County Commissioners Contracting Officer ISB, CONTRACTOR/OFFEROR, 15, DATS SIGNED 168, UNITBD STATES OF AMERICA 16C. DAT SIGNED BY (Signature of parron authorized ta sign) Signature of Contracting Offloer) OMB Conitrol Ne, 2120-0895 (SF-30) FAA Tamplate No. 14 (Reverse) (8/97) TSA/GPMD Gloagout Document (5), Rev, 10/27/2008