Okaloosa County BOCC — June 21, 2016 — WM 0408 Coordination

CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number: COO - 0408”0\/\] Tracking Number: | %28' ’Q Grant Funded: YES NO_/ Contractor/Lessee Name: \N(Q/ske, \u/\flfi L\Cm(‘-’r)‘}_ Pumcse%fi’c‘br\(\ Amerdvent = rnster Syedion Dal(krwfion pate/Term: Macch ‘3\’ 70177 1. [_] GREATER THAN $50,000 Amount: 2. L] GREATER THAN $25,000 Department: _<PW 3. [ 25,000 OR LESS Dept. Monitor Name: '}AVLL“('FCLII Document has been reviewed and includes any attachments or exhibits. Purchasing Coordination 2%&7(13‘1&&. Date: (p/q l' 4 Purcflas g Manager or Designee Joanne Kublik or Melissa Weisser Risk Management Review g . gl Approvedam\fi;n CLW L&}CM CMM&U M %%.% Ei%wm%flbk% pate. o~ T b vongl Risk MaImager“or designee Laura Porter or Krystal King /] County Attorney Review Date: é g /é /County A{(w} vGregory Tfitewart Lynn Hoshihara, Kerry Parsons or designee Following Okaloosa County approval: Contracts & Grants Document has been received: Date: Contracts & Grants Manager 4—,/{5}/6: T including but not limited to reasonable attorney fees, to the extent caused by the negligence, recklessness, or intentional wrongful conduct of the FRANCHISEE and other persons-employed or utilized by the FRANCHISEE in the performance of this contract. 157 CERTIFICATES OF INSURANCE 15.7.1 Certificates of insurance, in duplicate, indicating the job site and evidencing all required coverage must be submitted to and approved by Okaloosa County prior to the commencement of any of the work. The certificate holder(s) shall be as follows: Okaloosa County 602-C North Pearl Street Crestview, Florida 32536 15.7.2 All policies shall expressly require thirty (30) days written notice to Okaloosa County at the address set out above, or the cancellations of material alterations of such policies, and the Certificates of Insurance, shall so provide. 15.7.3 All certificates shall be subject to Okaloosa County’s approval of adequacy of protection and the satisfactory character of the Insurer. 15.7.4 The Certificates of Insurance shall disclose any and all deductibles or self-insured retentions (SIRs). ‘Deductibles-er-8Rs-imrexcess-of-$10;000-will-not-be-accepted . -unless-specifically-approved i writing-by-Okaloesa-County, All deductibles or —SIRs,-whether-approved-by-Okaloosa-County-er-not;-shall-be-the FRANCHISEE s~ —full-responsibility: -Ia-particular-the-FRANCHISEE shatl afford-futt-coverage-as- ~specifed tereiir to-entities-listed-as-Additional-Insured.— 15.7.5 In no way will the entities listed as Additional Insured be responsible for, pay for, be damaged by, or limited to coverage required by this schedule due to the existence of a deductible or SIR. Specific written approval from Okaloosa - 'County will only be provided upon demonstration that the FRANCHISEE has the Qkaloosa County Collection Franchise_Final ) Page 45 of 72