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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION » S <br />UTTILITIILITI ES <br />UTILITY WORK BY HIGHWAY CONTRACTOR AGREEMENT occ-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 <br />pplies: <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,Aint effective the day and year first written. <br />Gp��rl• Y. � �4fj��s� `. <br />UTILITY: INDIAN RIVER COUNTY <br />RV•tRinnaf vrnl �/ l�.-,��� .:zt � DATE: 11-05-19 <br />(Typed Name: Bob Solari) <br />(Typed Title: Chairman, Bc <br />Recommend Approval by the District Utility Office <br />est: Jeffrey R. Smith,XTrk of <br />CoUtrTY p��.P'*Circuit Court and Comptroller <br />O <br />Deputy Clerk <br />BY: (Signature) DATE: -t,42-11«( <br />FDOT Legal review <br />BY: (Signature _ <br />District Counsel <br />STATE OF FLORIDA <br />DEPARTMENT OF TRANSPORTA <br />BY: (Sianature <br />(Typed Name: Steve Braun, P.E. <br />(Typed Title: Director of Transportation Development) <br />FEDERAL HIGHWAY ADMINISTRATION (if applicable) <br />"/`,7,7-// 9 <br />DATE: <br />DATE: /%01 <br />BY: DATE: <br />(Typed Name: ) <br />(Typed Title: ) ApPROVED AS TO FORM <br />AND LEGAL S;iFFiCIENCY <br />BY <br />DYLANI REi \tG,0LD <br />Page 9 of 9 OOUNTY A17 ORNEY <br />