Okaloosa County BOCC — June 17, 2014 — Office of Criminal Conflict Renewal

CONTRACT/LEASE RENEWAL FORM Date: May 30, 2014 Company Name: Office of Criminal Conflict & Civil Regional Counsel, Region 1 Address: 227 N. Bronough Street, Suite 1125 City, State, Zip: Tallahassee, FL 32301 RE: Renew Lease Okaloosa County Water & Sewer Dear Sir, The Okaloosa County Water & Sewer Department agrees to renew the subject contract/lease, #L12-0392-WS for an additional term. The contract renewal period will be 7/1/2014 to 6/30/2015. The annual revenue received from this lease is $22,604.04, 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 Office of Criminal Conflict and Dept. Directof y| | (tka Coniractor: Civil Reg. Counsel, Region | Signature: \ 4 i Approved wi (Me Approved By: (as prescribed below oh item 1) Approved By: : Title: Regional Counsel, Region 1 (as prescribed below on item 1) Date: 6) WF Date: June 10, 2014 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 >S50K, 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.