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_r CERTIFICATION & ACKNOWLEDGEMENT <br />OF BUSINESS TYPE <br />This form must be signed in the presence of a Notary Public or other officer authorized to <br />administer oaths and submitted with the bid package on the specified bid opening date. The <br />undersigned proposer certifies that this proposal package is submitted in accordance with the <br />specifications in its entirety and with full understanding of the conditions governing this proposal. <br />BUSINESS ADDRESS of PROPOSER: <br />Bettoli Trading Corp. D/B/A Bettoli Vending <br />Company Name <br />Maurizio L Bettoli <br />Contact Person <br />6095 NW 167th street Suite D4 <br />Address <br />Hialeah FL 33015 <br />City State Zip <br />Telephone No. 305-626-0740 Fax No. 305-623-0108 <br />Email Address: Maurizio@BettoliVending. com <br />Federal ID. No. or Social Security No. 65-1057065 <br />INDICATE WHICH TYPE OF ORGANIZATION BELOW: <br />Individual Partnership Corporation X LLC Other <br />AUTHORIZED SIGNATURE OF PROPOSER <br />7 Maurizio L Bettoli <br />Signature Printed Name <br />If individual list dba: <br />If Corporation include Corporate Name: Bet .oli Trading Cor <br />Attest: <br />73'E�X <br />Corporate Secretary Signature: Z7 <br />Printed Name: -i1aWIri .i L Bettoli <br />