Okaloosa County BOCC — September 2, 2014 — Task order approval form C12-2007-TDC - 147 — reading text

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: AE Disapprove: O) Amount of Purchase: Date: q/22 14 Purchasing 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 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 NAME(S) POSITION(S) FIRM NAME: Ase Publishing lao Corssinas (v Agar Ney BY (PRINTED): Adelina lpving BY (SIGNATURE): Abe TITLE: Oftice. Manager DATE: Oulu 1 | dove ADDRESS: [455 Normandy Lw(alle Onl Nasr 3ni PHONE NO. 514- 4b4-TbY¥ lo _ E-MAIL DAPLO 1 CF 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 TORXK JYF Requesting Department's Suggested Vendor: Toronto Life Vendor's Address: 111 Queen Street East, Suite 320, Toronto, Ontario, M5C 1S2 : 416-955-4960 Point of Contact: Maggie Woodburn Vendor's Telephone N Sole Source J ustification: Visit Florida partnership (tactic of 2014/2015 Strategic Marketing Plan); readers are 70% more likely to m ve travelled NI Florida in the past 3 years; Canada's #1 city magazine. iN LE, wh vesynois yy he Requesting Department Head § J Pate/ 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: SD peak Bl22||4- Purciiasi g 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 i9 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’) with your business. YES NO 4 NAME(S) POSITION(S) FIRM NAME: “Toronto Lif, Maggiqine. BY (PRINTED): Lin Absa, wells BY (SIGNATURE): Kits ho TITLE: fEsociz kn fdolishne DATE: duly [be LOI ADDRESS: nat Ven SL. &.. Taro ro, 6M) MSC |$2— PHONE NO. 416- 455-U457 E-MAIL wells ©. tor nctol ite COM. 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 Toaxx UF Requesting Department's Suggested Vendor: Visit Florida International Travel Guide (BMI Publishin: Vendor's Address: BMI Publishing, Suffolk House, George Street, Croydon, Surrey, CR9 1Sr, UK o.: 44 (0)-20-8649-7233 Point of Contact: Sally Parker Vendor's Telephone Sole Source Justificatio : Visit Florida partnership (tactic of 2014/2015 Strategic Marketing Plan); only international travel quide Sanctioned by Visit Florida; Eusopean target audience; distributed in 17,markets. aN A, 8/01/2014 SLi Le Ti Requesting Depariment-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: fo Disapprove: Amount of Purchase: Date: Pin Hdlerak B/22/14- Pur¢hasing Director Signature Bate ° 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