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Board of County Commissioners
Purchasing Department
State of Florida
January 28, 2013 CONTRACT/LEASE RENEWAL FORM
EQ-The Environmental Quality Company
7202 East 8" Street
Tampa, FL 33619
Contract/Lease #: C02-0662-PW
Dear Sir:
The Okaloosa County Public Works Department wishes to renew the subject contract/lease, # C02-
0662-PW for an additional term. The contract renewal period will be October 1, 2012 to __ September
30, 2013.
The annual budgeted amount for this contract is $_75,000
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
(Your contact information) .
COUNTY REPRESENTATIVES AUTHORIZED COMPANY REPRESENTATIVE
7
Director:__Public Works Contractor: LO va lo. f Lf?
Director Signature:
County Official:___ Don R. Amunds
Approved By: Approved By: ZAZA LA
Title: CHAIRMAN Title: fetal fibaliber
Date: Date: L my, / -< ¥
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.
If you have any questions please contact Jack Allen at 850-689-5960, Fax-850-689-5998, e-mail:
jallen@co.okaloosa.fl.us