Okaloosa County BOCC — October 6, 2015 — Signed Contract-Lease Renewal Form C12-2003-PW

CONTRACT/LEASE RENEWAL FORM August 24, 2015 Island Sands Beach Srv of NW FL, LLC Attn: Brian Cox P.O. Box 146 Destin, FL 32540 RE: Renewal of Contract #C12-2003-PW Dear Brian Cox, The Okaloosa County Board of County Commissioners agrees to renew the subject confract/lease, # C12-2003-PW for an additional term. The contract renewal period will be Oct. 1. 2015 to September 30, 2018 . The annual budgeted amount for this contract is $.30,000.00 . All other terms and conditions of the original agreement shall remain in full force and effect through the duration of this renewal. 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 ) ) ls/end Sends Beacl~ Serace Dept. Dire Contractor__o& Nw FL LLC Signature) TSeran Col( oate_ YR Approved By: Approved By,:// / ok Z - (as prescrib below/or’{ item 1) Approved By: (as prescribed below on item 1) Title: fl KQ;A" f"*’/MM\CLQ?/\Q Moo R 7 Y I%=2015 Date: Date: 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 Cetlificate 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.