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Board of County Commissioners
Purchasing Department
State of Florida
January 6, 2014
CONTRACT/LEASE RENEWAL FORM
Superintendent Mary Beth Jackson
Okaloosa County School District
120 Lowery Place
Fort Walton Beach, FL. 32548
Lease #: LO7-0304-PS - Okaloosa County School Board Emergency Lease/Use of Buses
Dear Ms, Jackson:
‘The Okaloosa County Department of Public Safety wishes to renew the subject lease, #1.07-0304-PS for
an additional term. The lease renewal period will be July 1, 2014, to June 30, 2015. The annual
budgeted amount for this contract is $0.00.
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) to: Okaloosa
County Department of Public Safety, 90 College Boulevard East, Niceville, FL 32578.
COUNTY REPRESENTATIVES AUTHORIZED COMPANY REPRESENTATIVE
vale, Departmen The School Board of Okaloaga County,Florida
Wilani, Department, of Public Safety Gitalddsa/Gohty Sebo? bisiict f
: Contractor: 5
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Director: Ding
Director %
County Official:
Approved By: Abbrdvea/By: Lob ZL Lie
Rodney. Walker
Title: Title: Chairman
Date: bates February 10, 2014
County Department Instructions:
1) Obtain signatures from Department Director, authorized Company Representative and then
Purchasing Director <$25K, County Administrator <$50K or BCC Chairman >$50K, as
necessary. 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; Jack Allen, Purchasing Services Manager.
Tf you have any questions please contact Jack Allen at 850-689-5960, Fax-850-689-5998, e-mall:
jalien@co,okaloosa,fl.us