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• <br />a <br />Fax to: FRIENDS OF VERO BEACH PUBLIC Fax Number: 3193787671 Dater 01/25/99 <br />Credit Application <br />Current Customer Name: FRIENDS OF VERO BEACH PUBLIC Account 0: 6720951001 <br />L t BRAR}/ <br />ASSUMPTOR <br />Company Name; Indian River County Board of County Commissioners <br />Address: 1840 25th Street <br />City: Vero Beach State, FL <br />Phone: ( 561) 567-8000 Contact Person: <br />Billing Address: same Attention Finance Department <br />Equipment Location Address: <br />Type of Business: County Government <br />Zip: 32960 <br />o PROPRIETORSHIP o PARTNERSHIP o CORPORATION <br />Number of Years in Business: 74 Federal Tax ID 0: 59-6000674 <br />Officers: President Vice President Secretary <br />TRADE REFERENCES <br />Name of Supplier Account Number Telephone No. Contact Person <br />Name of Supplier Account Number Telephone No. Contact Person <br />First Union <br />Name of Bank/Branch <br />Bank References - Two year history <br />2658503962710 778-6132 Nancy Beckwith <br />Account Number Telephone No. Contact Person <br />Name of Bank/Branch Account Number Telephone No. Contact Person <br />Personal Information on Officers. Partners or Guarantors <br />Name Date of Birth Social Security No, <br />Home Address City State Zip Home Phone No, <br />Name Date of Birth Social Security No, <br />Home Address <br />