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2014004 Annual Asphalt Paving and Resurfacing <br /> Will your company extend these prices to other governmental agencies <br /> within the State of Florida? ye No <br /> The undersigned hereby certifies that they have read and understand the contents of this solicitation <br /> and agree to furnish at the prices shown any or all of the items above, subject to all instructions, <br /> conditions, specifications, and attachments hereto. Failure to have read all the provisions of this <br /> solicitation shall not be <br /> cause to alter any resulting contract or request additional compensation. <br /> Company Name: (/U h-) <br /> Company Address: 2275 f rid US7-y1 q 1 /31 ✓tel <br /> City, State rO j e 4 ch <br /> Zip Code 3 V`9 V <br /> Telephone:�7 7�' 7 ?0—37 -71 Fax: -77-1 ) 770- 37 <br /> !7 7 <br /> E-mail: bhee,-Oe , C0rp ne <br /> Business Tax Receipt Number::6-1 02 5 — <br /> FEIN Number: <br /> Authorized Signature: <br /> Date: 61 i zTr� <br /> Name: �l'1 Gl h /3e e I Title: V/Ge od re `!of of4 <br /> (Type/Printed) <br /> Page 13 of 16 <br /> 87 <br />