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Okaloosa County BOCC — June 3, 2014 — 2014 QBVC Check List for Boomer Beach Fitness — reading text

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Revised: March 12, 2013 Qualified Beach Vendor Certificate Processing Check List √ New Applications Renewal Date Received: May 12, 2014 Company Name: Boomer Beach Fitness, LLC Contact Person: Timothy Sullivan Phone #: (850) 499-3233 Email: boomerbeachfitness@gmail.com √ Application form √ $500 Application fee √ Designated Beach Area Permit √ Upland Property Owners Approval NA QBV Beach Vehicle Permit NA Vehicle insurance NA Vehicle registration NA $500 QBV Beach Vehicle Permit fee √ Hold Harmless Agreement √ Statement of Acceptance of Ordinance 13-07 √ Copy of Liability Insurance for $1,000,000 naming BCC as insured √ Copy of O.C. Local Business Tax Receipt NA Copy of Workman’s Comp. Insurance policy BCC Approval: _______________________

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