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STATE OF FLORIDA DEPARTMENT OF TWINSPORTATION <br />700-020-02 <br />CONSTRUCTION COMPLIANCE WITH <br />CONSTRUCTION <br />oa1ta <br />SPECIFICATIONS AND PLANS, <br />P%p2of3 <br />5.) Item No.: <br />Exception: <br />6.) Item No.: <br />Exception: <br />A false statement or omission made in connection with this certification is sufficient cause for suspension, revocation, or <br />denial of qualification to bid, and a determination of non -responsibility, and may subject the person and/or entity making <br />the false statement to any and all civil and criminal penalties available pursuant to applicable Federal and State Law. <br />State of Florida <br />County of <br />Sworn to and subscribed before me this day <br />Of , by <br />(Print name of person signing certification) <br />Notary Public <br />Commission Expires <br />Personally Known or Produced Identification <br />Type of Identification Produced <br />State of Florida <br />County of L . tJ'J9'f'e . <br />Sworn to and subscribed before me is 41A day <br />of � i , 1 , by I AVI /X (. U16 eCJZ <br />.. / (Pd"me of person signing certification) <br />-SUE J. GUE7TLER <br />MY COMMISSION # FF923607 <br />EXPRES October 31 2019 <br />Commission <br />Personally Known mob— or Produced Identification <br />Type of Identification Produced <br />Quality Control Manager <br />By <br />Company <br />Kerns Construction & PropertV Management <br />Contractor <br />By <br />Executive Vice President <br />Title <br />P84 <br />