Okaloosa County BOCC — August 19, 2014 — PM TO 134 — reading text

(if applicable ) Peter Mayer Okaloosa TOO-- Page 5 Confidential 11 11242v2  SINGLE SOURCE PURCHASE DATA SHEET Date: _2_127_12_0_14_ _ _ _ PR No.: _ _ _ _ _ Requestor: _P _et_er_M_ay;_e_r ____ Phone No.: 504.581 .7191 Department/ Division : Tourist Development Department (TDD) Item Description: 2013/2014 BP Additional Online Media Pass Through Costs, Task Order 134 Requesting Department's Suggested Vendor:_A_da_ra_& _R_o_ck_e_ttu_e_l- - - - - - - - - - - - - Vendor's Add~ess : 222 w. Hubbard St. Suite #400 Chicago, IL 60654 Vendor' lephone No.: _B3_2_.4_39_.o_s n_ _ _ _ _ _ _ _ Point of Contact:_R_os_s_P_et_er_s_ _ _ _ _ _ __ Vendor offers high reach at competitive pricing against our target market. 3/5/2014 7 /DatE? REVIEW BY PURCHASING DEPARTMENT VERIFY IF OTHER SOURCES OF SUPPLY MEETS THIS NEED + Vendor #1 Contact: _ _ _ _ _ _ _ _ _ _ _ _ _ _ Phone No.: Vendor #2 Contact: - - - - - - - - - - - - - - - P h o n e No.: Vendor #3 Contact: - - - - - - - - - - - - - - P h o n e 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: Date: Pure 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 19  Tourist Development Department Conflict of Interest Disclosure Certification TO BE USED FOR SOLE -SOURCE ACQUISITIONS INVOLVING MULTI-NATIONAL ENTITIES Peter Mayer Adverti sing, Inc. ("Peter Mayer") affi rms, to t he best of its know ledge, information and belief, th at no coun ty employe e, elected official, me mbe r o f the Tourist Developm ent Counci l no r any bu siness associate or relative of an elected o fficia l, as defined in section 112.3143(1), Florida Statutes, has any financial interest, direct or ind irect, in the procurement of goods or services by the vendors list ed below: Adara Orbitz Bi ll Dance Outdoors Pi ne Ridge Burs t Media Priceline Canadian Traveller RGM All iance Che ap Tickets Rocket fuel Collinson M edia Satellite Rad io (Sirius/XM) Destination media Scripps Expedia Southwest Spirit Faceboo k Specific Media US Foo d & Wine/Travel & Leisure Texas Monthly Google Trave l Zoo Home Away Trip Advisor HomeAway.com Twitter Horizons Virtual Tourist Hotel.com Visi t Florida Lamar Oudoor Yahoo Media Mind d vendors we re selected solely based on their qua lifi ca tions, expe rienc e, reputa tion, cost and ava i l bilit and not due to any actual or perceived relationsh ip these vendors have or may have with any cou ty em loyee o r elected official. James Geiger Print Name 1.29.14 Date