Okaloosa County BOCC — September 16, 2014 — AC-Form2 — reading text

CONTRACT/LEASE RENEWAL FORM Date: August 18, 2014 ¢ 99-03-14A10:07 RCVD Anderson Columbia, Inc. Attn: Kevin Wall 1301-C West Highway 90 Holt, FL 32564 RE: Limestone, Limerock, and Asphalt Milling Materials Contract Dear Kevin: The Okaloosa County Board of County Commissioners agrees to renew the subject contract/lease, #C14-2091 PW for an additional term. The contract renewal period will be 9/30/14 to 9/30/15. The annual budgeted amount for this contract is $ 250,000. 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 Contractor: Jadersony Columb te “a “Ene. Signature: | Nf Approved By: Lome fic a Approved By: Hd ’ Ernie Padgett Approved By: Title: Viee President Charles K. Windes, Jr., Chairman Date: Date: Sf 2/iy County Department Instructions: 1) Obtain signatures from Department Director, authorized Company Representative and then 2) 3) 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 Certificate of Insurance. (If applicable). Keep a copy of this form for your records. Send original to Purchasing Services Coordinator. If you have any questions please contact the Purchasing Director at 850-689-5960, Fax: 850- 689-5998.