Okaloosa County BOCC — September 16, 2014 — FortWaltonConcreteForm — reading text

CONTRACT/LEASE RENEWAL FORM Date: August 18, 2014 Company Name: FWB Concrete & Crestview Ready Mix Attn: Zac Sims Address: 26 Industrial St, NW Fort Walton Beach, FL 32548 RE: C14-2105-PW Dear Mr. Sims: The Okaloosa County Board of County Commissioners agrees to renew the subject contract/lease, #C14-2105-PW for an additional term. The contract renewal period will be 10/1/14 to 9/30/15. The annual budgeted amount for this contract is $250,000. == sugyectT To Nev farce Seueoure ATTACHED. 4 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 REPRESENTATIV. AUTHORIZED COMPANY REPRESENTATIVE Dept. Directo ; Contractor: fer ware Comete, rwe Signature: . , A > ruse E Creel Approved ® few Approved By:\_ “tyr? LZ. iy Dr ff ERNIE PADGETT ae 7 Approved By: Title: ce ~PersioE wt CHARLES K. WINDES, JR. CHAIRMAN Date: Date:__27 Augusi” pore 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 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 Director at 850-689-5960, Fax: 850- 689-5998.