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_AIADocument A305 <br />TIVI <br />-1986 <br />Contractor's Qualification Statement <br />The Undersigned certifies under oath that the information provided herein is true and sufficiently complete so as not <br />to be misleading. <br />SUBMITTED TO: <br />City of Sunny Isles Beach <br />ADDITIONS AND DELETIONS: <br />The author of this document has <br />added information needed for its <br />ADDRESS: <br />completion. The author may also <br />City Clerk <br />have revised the text of the <br />18070 Collins Avenue, 4th Floor <br />original AIA standard form. An <br />Sunny Isles Beach, Fl 33160 <br />Additions and Deletions Report <br />that notes added information as <br />SUBMITTED BY: Azulejo Inc. <br />well as revisions to the standard <br />form text is available from the <br />author and should be reviewed. <br />A vertical line in the left margin of <br />this document indicates where <br />NAME: Leyvis T. Quintana <br />the author has added necessary <br />information and where the author <br />20200 West Dixie Hwy. <br />has added to or deleted from the <br />ADDRESS: Suite 805-A. <br />original AIA text. <br />Aventura, FI 33180 <br />This document has important <br />legal consequences. <br />PRINCIPAL OFFICE: 20200 West Dixie Hwy. Suite 805-A. Aventura, FI 33180 <br />Consultation with an attorney <br />is encouraged with respect to <br />its completion or modification. <br />[x ] Corporation <br />This form is approved and <br />[ ] Partnership <br />recommended by the American <br />Institute of Architects (AIA) and <br />] Individual <br />The Associated General <br />[ ] Joint Venture <br />Contractors of America (AGC) for <br />use in evaluating the <br />[ ] Other <br />qualifications of contractors. No <br />endorsement of the submitting <br />NAME OF PROJECT (if applicable): <br />party or verification of the <br />information is made by AIA or <br />AGC. <br />TYPE OF WORK (file separate Form for each Classification of Work): <br />[ x ] General Construction <br />[ ] HVAC <br />[ ] Electrical <br />[ ] Plumbing <br />( ] Other (please specify) <br />AIA Document A305VA —ION. Copyright© 1964, 1969, 1979 and 1986 by The American Institute of Architects. All rights reserved. WARNING, This <br />AIA" Document is protected by U.S. Copyright Law and Interpellonal Treaties. Unauthor)zed reproduction or distribution *I this AiAJ9 Document, or 1 <br />any portion of it, may result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This <br />document was produced by AIA software at 13:28:18 on 03/22/2006 under Order No.1000201877_1 which expires on 10/11/2006, and is not for resale_ <br />User Notes: (2533789901) <br />