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.: Signature <br />Service <br />BILL TO INFORMATION <br />ACCOUNTS PAYABLE CONTACT <br />Company Name: City of Sunny Isles <br />Name: Susan Simpson <br />Address: 18070 COLLINS AVE <br />Phone Number: 305 792-1706 <br />Address 2: SUNNY ISLES BEACH <br />Email: SSimpson@sibfl.net <br />City: SUNNY ISLES BEACH <br />Email Address for Invoice Delivery: <br />State: FL <br />Email Address for Statement Delivery <br />(if different from above): <br />Zip Code: 331602723 <br />TAX STATUS <br />Are you fax exempt? (Check one) Yes No <br />If yes, please provide fax exempt certificate <br />PURCHASE ORDER & WORK ORDER REQUIREMENTS <br />Contractual Services Yes No <br />Do you require a Purchase Order to be listed on your invoices for this service <br />agreement (Check one)? <br />If yes to above, please provide contact for PO renewal: <br />Name: <br />Phone: <br />Email Address: <br />Purchase Order Expiration Date: <br />Purchase Order Number: <br />Purchase Order Renewal <br />Frequency (Check one) <br />Monthly Quarterly Annual <br />Page 1 15 <br />296 <br />