Laserfiche WebLink
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 />reference purposes only and do not change the terms of the document. By signing this document, the UAO <br />hereby represents that no change has been made to the text of this document except through the terms of the <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 <br />Appendix entitled "Changes to Form Document." <br />IN WITNESS WHEREOF, the parties hereto have executed this <br />UTILITY <br />effective the day and year first written. <br />iv 0 �1 M!5 <br />Chairman <br />(Typed Title: ) <br />Recommend Approval by the District Utility Office <br />DATE:January 31, 2023 <br />BY: (Signature) DATE: <br />FDOT Legal review <br />BY: (Signature) DATE: <br />District Counsel <br />STATE OF FLORIDA <br />DEPARTMENT OF TRANSPORTATION <br />BY: (Signature) DATE: <br />(Typed Name: Steven C. 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 />Attest: Jeffrey R. Smith, Clerk of <br />Circuit Court and Comptroller <br />'�nVl <br />Deputy aerK <br />DATE: <br />P,laP)10- VE-) AS TO FORM <br />LE,—:AL SUFFiCIENCY <br />Page 9of10 ^ 11l?'1TyAT-rr)r—;14E `s' <br />