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Name of Affiliate Name of County Commissioner Relationship <br /> or entity or employee <br /> BY : P IP D . W NER 0 . , LLC , GENERAL PARTNE <br /> or <br /> ( Signature) <br /> PHILIP D . WAGNER , PRESIDENT <br /> 6 / 8 / 04 <br /> (Date) <br /> STATE OF PENNSYLVANIA <br /> COUNTY OF BERKS <br /> The foregoing instrument was acknowledged before me this b day of �y '� , 20. by <br /> who is personally known to me or who has <br /> produced as identification. <br /> NOTARY PUBLIC <br /> SIGN: ^''�'� ' <br /> PRINT : RDSCmoLrj Sc bG -t- c f <br /> State of Florida at Large <br /> My Commission Expires : <br /> (Seal) <br /> NOTARIAL SEAL <br /> ROSEMARY SOBOTOR, Notary Public <br /> Spring Twp., Berks County, PA <br /> MY Commission Expires 7.15-2007 <br /> FAPurchasing\Bids\2003 -2004 FY (6000)\6080 Resurfacing on CR512 from SR 60 to Fellsmere Farms\6080 Bid Document.doc <br /> Page 43 of 61 <br />