Okaloosa County BOCC — September 16, 2014 — First Southwest Company Contract Renewal Form — reading text

CONTRACT/LEASE RENEWAL FORM Date: 8/27/2014 First Southwest Company Atin: 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 fo: renew the subject contract/lease, #C04-1098-BCC for an additional term. The contract renewal period will be October 1, 2014 to September 30, 2015. If you would like to review the previously accepted contract, please feel free to view on-line at http://www.co.okaloosa. fLus/contracts/contra_pdf/C04-1098-BCC.pdf If you are in agreement, please sign below and return this form along with a current Certificate 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 Dept. Director = Contractor: Fiesk Sorkhuseg} Coun pou 4 Signature: eater / Z c Approved By; b Approved By: cu a het (as prescribed below on item 1) Approved By: Title: Sr. Vice Ry sided (as prescribed below on item 1) Date: Date: g/2 a/14 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. (lf 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.