Okaloosa County BOCC — December 31, 2012 — Matrix Contract Extension

Board of County Commissioners Purchasing Department State of Florida November 28, 2012 CONTRACT RENEWAL FORM Matrix Design Group, Inc. Attn: Celeste Werner 2224 W. Northern Avenue, Suite D240 Phoenix, AZ 85021 RE: Contract C11-1860-GM JLUS Small Area Study Dear Ms. Werner: The Okaloosa County Growth Management Department wishes to renew contract C11-1860-GM for an additional term. The contract renewal period will be from October 31 to December 31_, 2012. If you are in agreement, please print and sign two (2) copies of this forms and return it, along with a current Certificate of Insurance listing Okaloosa County as co-insured to: Elliot Kampert, Growth Management Director 1804 Lewis Turner Blvd Ft Walton Beach, FL 32547. COUNTY REPRESENTATIVE AUTHOURIZED COMPANY REPRESENTATIVE Requesting Dept: __ Growth Management ‘ Contract Metrix Design Group / US llop A= nem Pron L I Approved By: lh { Ap BA \/ LL ki Lt 4 — } Ve yy ww, 4 to CA, wr Print Name: _ Elliot L. Kampert Print Namé: celeste Boccieri Werner Title: Director Title: __ Vice President Date: n/a 2/20 VR Date: \\ Jas/aoia County Department Instructions: 1) Obtain signatures from Department Director and authorized Company Representative. 2) Make sure the company provides a current Certificate of Insurance. (If applicable) 3) Keep a copy of this form for your records. 4) 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 Approved by Board of County Commissioners: Date: Don R. Amunds, Chair