Okaloosa County BOCC — February 17, 2015 — NetworkCablingAndRepairContractRenewals — reading text

CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/lease Number: C Ilf -ciJ IS l, -]:.5 Grant Funded: YES__ NO X 1. 0 GREATER THAN $50,000 2. 0 GREATER THAN $25,000 3. 0 $25,000 OR LESS Document has been reviewed a nd includes any attachments Purchasing Review Date: /-J.-r/5 Joanne Kublik Risk Management Review Approved as written: Date: 1- d (0 -15 Kay Godwin or Krystal King County Attorney Review Approved as written: c:::::: ~ ~ ........ Date:'_'-J--/2-_b /-J--1S-=--_ coun~ ~ G'§Ory T. Stewart or Lynn Hoshihara Following Okaloosa County approval: Contracts & Grants Document has been received: Date:_ _ __ __ _ _ _ Contract:; & Grants ManaJ{er  CONTRACT/LEASE RENEWAL FORM Date: January 7, 2015 GSC Systems, Inc. Attn: Caralee M. Gibson 15 Industrial Street NW Fort Walton Beach, FL 32548 RE: Contract#C14-2156-IS Dear Caralee: The Okaloosa County B29!c:kgf County Commissioners agrees to renew the subject contract/lease, #C14-21~ I s'%r an additional term . The contract renewal period will be 02/18/15 to 02/17/16. The annual budgeted amount for this contract could possibly exceed $50,000.00. 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). AUTHORIZED COMPANY REPRESENTATIVE Dept. Director Signature:_ _ _----=~--_=...""i;....... Approved BY: ~2::~~~~~ A PPro v ed By: ---"'::LQ£.l£l.<L.t:.6<I.t:....-lL.!-tf--'~IL!!!!::::..:....::: (as prescrH ,/ JOHN HOYSTAD . COUNTI 'ADM INISTRATOR Approved By: _ _ _ _ _ _ __ Title: T>resldwt (as prescrib NATHAN D. BOYLES CHAIRMAN Date:_ __ _ _ _ __ _ __ Date: 8 JinlB4j 2015 County Department Instruc,tions: 1) Obtain signatures from Department Director, authorized Company Representative and then Purchasing Director <$25K and less, County Administrator <$SOK 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, Fox: 850­ 689-5998.  ~ -, ACORD­ DATE (MM/DDIYYYY) ~ CERTIFICATE OF LIABILITY INSURANCE I 7/31/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ~2~1~CT House J Kevin Campbell Agency r~gN~oE.tl: (800)508-9126 I iAic FAX Nol: (877)234-6089 POBox 9435 jtD~~ss:hbeckham@Workcompspecia1ists.com INSURER(S) AFFORDING COVERAGE NAIC# Panama City Beach FL 32417 INSURER A :Retail First Insurance Company 10700 INSURED INSURER B: GSC Systems, Inc. INSURERC: 15 Industrial St NW INSURERO: INSURER E : Ft Walton Beach FL 32548 INSURER F : COVERAGES CERTIFICATE NUMBER'CL1472808004 REVISION NUMBER' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWIN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ISUBR ~~~ IWVD INSR LTR lYPE OF INSURANCE POLICY NUMBER I (~~hlg~l (~g~6%iMYl LIMITS GENERAL LlABILIlY EACH OCCURRENCE $ - - OMMERCIAL GENERAL LIABILllY ~~~~~J?E~~~~~nce) $ r-­ CLAIMS-MADE D OCCUR MED EXP (Anyone person) $ PERSONAL & ADV INJURY $ I--­ GENERAL AGGREGATE APn $ - ~'L AGGREAE LIMIT PER: PRODU CTS· COMPIOP AGG $ POLICY j~2T LOC $ AUTOMOBILE LlABILllY fE~r.::~~~d~~t~I NGLE LIMIT $ - ANY AUTO BODILY INJURY (Per person) $ - ALL OWNED ,-­ SCHEDULED BODILY INJURY (per accident) $ ~ AUTOS r-­ AUTOS NON·OWNED r:"?~~C~d~t?AMAGE $ r-­ HIRED AUTOS I--­ AUTOS H $ UMBRELLA LIAB EACH OCCURRENCE $ r-­ OCCUR EXCESS LlAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LlABILllY X I T~~~rf'JI¥S I IOl~' ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? YIN DNIA 7/26/2014 7/26/2015 E.L. EACH ACCIDENT $ 1,000,000 (Mandatory in NH) 0520-42628 E.L. DISEASE · EA EMPLOYEE $ 1 000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE· POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCAnONS I VEHICLES (AttaCh ACORD 101, Additional Remar1<s Schedule, if more space is required) Alarm Systems Contractor License #EFOOO0906 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Okaloosa County Dept of Growth Management AUTHORIZED REPRESENTATIVE 812 E James Lee Blvd Crestview 32539 Kevin Campbell/HOLLY