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<br />A TT ACHMENT E continued <br /> <br />Provider's Name: <br /> <br />2. REQUIRED LIST OF SUPPLIERS ON COUNTY CONTRACT <br /> <br />In compliance with Miami-Dade County Ordinance 97-104, the Provider submits this list of <br />suppliers who will supply materials for the Scope of Services to the Provider, if this Agreement <br />is for $~ or more. <br />100.. 000 <br /> <br />Proposer must fill out this information. If Provider will not use suppliers, Provider must state <br />"No suppliers will be used", do not state "NA". <br /> <br />Name of Supplier <br /> <br />City and State <br /> <br />I hereby certify that the foregoing information is true, correct and complete. <br /> <br />Signature of Authorized Representative: <br /> <br />Title: <br /> <br />Date: <br /> <br />Firm Name: <br /> <br />Fed. ID No.: <br /> <br />City/State Zip: <br /> <br />Address: <br /> <br />Telephone: <br /> <br />Fax: <br /> <br />20f2 <br />