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This Agreement will be effective on , 20_ (the date the Agreement is approved by the <br />Indian River County Board of County Commissioners, which is the Effective Date of the Agreement). <br />OWNER: CONTRACTOR: <br />INDIAN RIVER COUNTY <br />By: By: <br />TBD, Chairman (Contractor) <br />By: (CORPORATE SEAL) <br />Jason E. Brown, County Administrator <br />APPROVED AS TO FORM AND LEGAL SUFFICIENCY: <br />By: <br />Dylan Reingold, County Attorney <br />Jeffrey R. Smith, Clerk of Court and Comptroller <br />Attest: <br />Attest <br />Address for giving notices: <br />License No. <br />(Where applicable) <br />Deputy Clerk <br />(SEAL) Agent for service of process: <br />Designated Representative: <br />Name: Designated Representative: <br />Title: Name: <br />Address: Title: <br />Phone Address: <br />Email <br />Page 10 of 15 <br />Phone: <br />Email: <br />(If CONTRACTOR is a corporation or a partnership, <br />attach evidence of authority to sign.) <br />106 <br />