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or sus" P� <br />FirmName: <br />A5_.ggc1.A 7 -ed Z//VT//VG AC_40Cok---7?_0&_S' XV0, <br />Street Address: <br />/37,2 /V Vc/ <br />Mailing Address (if different): <br />FT 330 <br />Telephone No. 3ga - 6,2-3— %600 Fax No. / O -r ` �% ' 1? 7 <br />Email Address: EQ de IG Q ►am,1 , COM. FEIN No. <br />*'By signing this document the vendor agrees to all Terms <br />Signatur . <br />(Sign 7ame <br />of aut�i�zed agent) <br />Print:D 8136- C L <br />Title:_ <br />THE EXECUTION OF THIS FORM CONSTITUTES THE UNEQUIVOCAL OFFER OF VENDOR TO BE BOUND BY THE TERMS <br />OF ITS SUBMITTAL. FAILURE TO SIGN THIS SOLICITATION WHERE INDICATED ABOVE BY AN AUTHORIZED <br />REPRESENTATIVE SHALL RENDER THE SUBMITTAL NON-RESPONSIVE. THE CITY MAY, HOWEVER, IN ITS SOLE <br />DISCRETION, ACCEPT ANY SUBMITTAL THAT INCLUDES AN EXECUTED DOCUMENT WHICH UNEQUIVOCALLY BINDS <br />THE VENDOR TO THE TERMS OF ITS OFFER. <br />City of Sunny Isles Beach I Request to Qualify No. 22-12-01 <br />