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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION 710-010-22 <br />UTILITIES <br />UTILITY WORK BY HIGHWAY CONTRACTOR AGREEMENT OGc-06/19 <br />(AT UTILITY EXPENSE) <br />appendix entitled Changes to Form Document. <br />You MUST signify by selecting or checking which of the following applies: <br />❑ No changes have been made to this Form Document and no Appendix entitled "Changes to Form <br />Document' is attached. <br />® No changes have been made to this Form Document, but changes are included on the attached Appendix <br />entitled "Changes to Form Document." <br />IN WITNESS WHEREOF, the parties hereto have executed this Agreement effective the day and year first written. <br />UTILITY: INDIAN RIVER COUNTY•......M.sS�• <br />o^�F9 <br />BY: Si nature <br />(Typed Name: Bob Solari) A <br />(Typed Title: Chairman, Board of CountyCommis nVe� ' ,j <br />Recommend Approval by the District Utility Office or. <br />BY: (Signature) <br />FDOT Legal review <br />DATE: 11-05-19 <br />Jeffrey R. Smith. Clerk of <br />t Court and ComptroUw <br />1 <br />Deputy Clerks <br />DATE: <br />BY: (Signature) DATE: <br />District Counsel <br />STATE OF FLORIDA <br />DEPARTMENT OF TRANSPORTATION <br />BY: (Signature) DATE: <br />(Typed Name: Steve Braun, P.E.) <br />(Typed Title: Director of Transportation Development) <br />FEDERAL HIGHWAY ADMINISTRATION (if applicable) <br />BY: <br />(Typed Name: ) <br />(Typed Title: ) <br />DATE: <br />APPRO'm"ED AS TO FORM <br />AND LEGAL SUFFICIENCY <br />BY....r,...,,, <br />Page 9 of 9 DYLAN RI NGOI_D <br />OQWNTY ATTORNEY <br />