Okaloosa County BOCC — June 7, 2016 — Annual Lease Fee 2016-2017 Invoice

DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIPTS SECTION POST OFFICE BOX 3070 TALLAHASSEE, FL 32315-3070 Bill To: OKALOOSA COUNTY, FLORIDA BOARD OF COUNTY COMMISSIONERS INVOICE 1250 E. ELGIN PARKWAY SHALIMAR, FL 32579 ** INVOICE / INSTRUMENT INFORMATION ** Invoice #: 88633 Instrument #: 460017681 Invoice Date: 04/15/2016 Expiration Date: 05/04/2016 Due Date: 05/15/2016 Extended Term Fee: NO Rate: BASE RATE Location: OKALOOSA ISLAND PIER ** IMPORTANT REMINDERS ** If paying by mail, please return invoice with your payment to the above address. Online payment by check, credit card or debit card is available at http://www.fldepportal.com/go/pay-invoices/. Late payments are subject to a 12% Interest fee pursuant to FAC 18-21.011(1)(b)11. INFORMATION ANNUAL LEASE FEE DATA Net Description Memo Object| Square | Rate |Discount $xtenged *Amount Feet erm Fee ANNUAL LEASE BOAT SLIP RENTAL " FEE 2016/2017 DISCOUNT APPLIED | 021017 23,421 [0.171906 30% ¥ $2,818.35 Subtotal $2,818.35 Sales Tax (0.0%) $0.00 County Tax (0%) $0.00 Note: PLEASE COMPLETE THE ENCLOSED INCOME REPORTING FORMS Total $2,818.35 AND RETURN WITH YOUR REMITTANCE Invoice Balance Due $2,818.35 Instrument/Lease $2,818.35 ANNUAL LEASE FEE FORMULA = BASE FEE* - DISCOUNT + EXTENDED TERM FEE *BASE FEE = Base Rate x Net Square Feet OR *BASE FEE = Minimum Rate DISCOUNT = Base Fee x Discount Percentage EXTENDED TERM FEE = Base Fee x Extended Term Fee Percentage For any questions concerning this invoice, please call the Division of State Lands at (850) 245-2555,