Okaloosa County BOCC — September 16, 2014 — CW-Form2

CONTRACT/LEASE RENEWAL FORM Date: August 18, 2014 Joe 2I-14P 12244 REVO CW Roberts Contracting, Inc. Attn: Darryl Carpenter 160 Industrial Park Rd Freeport, FL 32439 RE: Limerock, Limestone & Asphalt Milling Material Contract Dear Darryl: The Okaloosa County Board of County Commissioners, agrees to renew the subject contract/lease, #C14-2095 PW for an additional term. Tne contract renewal period will be 9/30/14 to 9/30/15. The annual budgeted amount for this contract is $ 250,000. 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). COUNTY REPRESENTATIVES AUTHORIZED COMPANY REPRESENTATIVE Contractor;(2a/ Aeheale Crbetg de, Approved By: ERNIE PADGETT Approved By: Title: [ice a. v CHARLES K. WINDES, JR. CHAIRMAN Date: Date. 2S Cor County Department Instructions: Dept. Direct Signature: Approved By: 1) Obtain signatures from Department Director, authorized Company Representative and then Purchasing Director <$25K and less, County Administrator <$50K 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, Fax: 850- 689-5998.