Okaloosa County BOCC — August 4, 2015 — APAC Renewal (C14-2082-PW)

CONTRACT/LEASE RENEWAL FORM Date:May 19, 2015 Company: APAC Mid-south Attn: Turnstall Perry Address: 4375 McCoy Drive City, St, Zip: Pensacola, FI 32503 RE: Contract renewal C14-2082-PW Dear Mr. Perry The Okaloosa County Board of County Commissioners agrees to renew the subject contract/lease, # C14-2082-PW for an additional term. The contract renewal period will be 10/1/15 to 9/30/16 . The annual budgeted amount for this contract is $250,000 . All other terms and conditions of the original agreement shall remain in full force and effect through the duration of this renewal. 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). COUNTY REPRESENTATIVES AUTHORIZED COMPANY REPRESENTATIVE MIDSOUTH PAVING, INC Dept. Director Contractor; L Signature: \J [V Jason Autrey Date: ) /M Q ) ™ ' ‘ Approved By: Approved B@/fi%% (as prescribedbelow gh item 1) Date: é/ fl;/)’\ ‘ | Tunstall B. Perry IV (as prescribed below on item 1) Date: Ijo’re: &-C-Zys” 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 Cerificate of Insurance. (If 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. CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number: [V ' | -QO{Q /)Y\/ Tracking Number: /3%72 = Grant Funded: YES NO__X Contractor/Lessee Name: A(ZA((‘ Mot M) Purpose I/é:l W Date/Term:__ 7 / 301}11(‘; — Vot poroun/ 1. & ereater tHan $50,000 Amount: $9 250,570 2. L] GReaTER THAN $25,000 Department: 3. [] $25,000 OR LESS Dept. Monitor Name: A‘Q‘f’fé(/\ Document has been reviewed and include&jany attachments or exhibits. Purchasing Review Procurement requirements-are phe : / B2 A I\ pate:__ [/ -/3-I5 Purchasifig Dire@r or Des)g/nee Joanne Kublik or Sunnie Estes Risk Management Review Approved as written: %wj@d%m Date: m"l%”lf) Risk I\}Ianager or designee - Laura Porter or Krystal King County Attorney Review Approved as written: Date: County Attorney Gregory T. Stewart or Lynn Hoshihara Following Okaloosa County approval: Contracts & Grants Document has been received: Date: Contracts & Grants Manager Joanne Kublik From: Parsons, Kerry [KParsons@ngn-tally.com] Sent: Wednesday, July 15, 2015 8:58 AM To: Joanne Kublik; Lynn Hoshihara Subject: RE: APAC Mid South APAC approved for legal purposes From: Joanne Kublik [mailto:jkublik@co.okaloosa.fl.us] Sent: Tuesday, July 14, 2015 4:20 PM To: Parsons, Kerry Subject: APAC Mid South Sorry to be a bother and truly this can wait for the next agenda. | have the Anderson Columbia approval but not the APAC Mid South. When you have a chance. Thanks, Jo Joanne Kublik, Contracts and Lease Coordinator Okaloosa County Purchasing Department 602-C North Pearl Street Crestview, Florida 32536 (850) 689-5960 jkublik@co.okaloosa.fl.us Please note: Due to Florida's very broad public records laws, most written communications to or from County employees regarding County business are public records, available to the public and media upon request. Therefore, this written e-mail communication, including your e-mail address, may be subject to public disclosure.