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Okaloosa County BOCC — March 18, 2013 — 2013 Check List for Days of Shade QBVC — reading text

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Revised February 11, 2013 Qualified Beach Vendor Certificate Processing Check List ___ New Applications __√_ Renewal Date Received: February 19, 2013 Company Name: Days of Shade Beach Service Contact Person: Hiram Atwell Phone #: (214) 458-9383 Email: hiramjatwell@cox.net __N/A Application form ___√__ $500 Application fee ___√__ Designated Beach Area Permit ___√__ Upland Property Owners Approval ___√__ Authorized Beach Vehicle Permit ___√__ $500 Beach Vehicle Permit fee per vehicle ___√__ Hold Harmless Agreement ___√__ Statement of Acceptance of Ordinance 13-07 ___√__ Copy of Liability Insurance for $1,000,000 Naming BOCC as insured. ___√__ Copy of O.C. Local Business Tax Receipt for the State of Florida __N/A_ Copy of Workman’s Comp. Insurance Policy ______ BCC Approval: _______________________

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