Okaloosa County BOCC — May 20, 2014 — PS Medical Director Contract Renewal

Board of County Commissioners Purchasing Department Bean Geutly Coates }— =< State of Florida CONTRACT/LEASE RENEWAL FORM April 9, 2014 Dr. Christopher D. Tanner, M.D. P.O. Box 5500 Destin, FL 32540 RE: Contract #C09-1721-PS (Medical Director) Dear Dr. Tanner: The Okaloosa County Department of Public Safety agrees to renew the subject contract, #C09-1721-PS for an additional term. The contract renewal period will be from October 1 2014, to September 30, 2015. The annual budgeted amount for this contract is $16,000.00. 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 Dept. Director _/ Z Yl oa ms oe : 7 4 HE sntractor: Dr. Christoph sranner, M.D. Dino J. Villani, Public Safety Director ‘/ | Ans Approved By: Approved By: Charles K. Windes, Jr. Title: Chairman Title: Medical Director Date: Date: y [io fut County Department Instructions: 1) Obtain signatures from Department Director, authorized Company Representative and then Purchasing Director <$25K, 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 (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 Manager at 850-689-5960, Fax-850-689-5998.