Laserfiche WebLink
<br />ATTACHMENT E <br /> <br />MIAMI-DADE DEPARTMENT OF HUMAN SERVICES <br />BYRNE GRANT ADMINISTRATION <br /> <br />Name of Organization: Ci ry Or SJtvlV ~/ ]'SLE<" g~.(K': ~\Address: <br /> <br />PROVIDER'S DISCLOSURE OF SUBCONTRACTORS AND SUPPLIERS <br />(Ordinance 97-104) SUNNY ISLES BEACH P.O. <br />17070 COLLINS AVE. SUITE 255 <br />SUNNY ISLES BEACH, FL 33160 <br /> <br />REQUIRED LISTING OF SUBCONTRACTORS ON COUNTY CONTRACT <br /> <br />In compliance with Miami-Dade County Ordinance 97-104, the Provider must submit the list of first tier <br />subcontractors or sub-consultants who will perform any part of the Scope of Services Work, if this <br />Contract is for $100,000 or more. <br /> <br />The Provider must complete this information. If the Provider will not utilize subcontractors, then the <br />Provider must state "No subcontractors will be used"; do not state "N/A". <br /> <br />NAME OF SUBCONTRACTOR OR SUB-CONSULTANT <br /> <br />ADDRESS <br /> <br />CITY AND STATE <br /> <br />N() Sub- Co (yr,r-c<..c-rO ('S LU'{ (f ["--Sf: <br /> <br />l) ,S (:~ 7) <br /> <br />REQUIRED LIST OF SUPPLIERS ON COUNTY CONTRACT <br /> <br />In compliance with Miami-Dade County Ordinance 97-104, the Provider must submit a list of suppliers <br />who will supply materials for the Scope of Services to the Provider, if this Contract is $100,000 or <br />more. <br /> <br />The Provider must fill out this information. If the Provider will not use suppliers, the Provider must <br />state "No suppliers will be used", do not state "N/ A". <br /> <br />NAME OF SUPPLIER <br /> <br />ADDRESS <br /> <br />CITY AND STATE <br /> <br />NO <br /> <br />S U ppLJ l=f?-S <br /> <br />Vi/I I J <br /> <br />73 (~ lJS ED <br /> <br /> <br />Signature of Authorized Representative: <br /> <br />Title: Mayor Date: <br /> <br />Firm Name: City of Sunny Isles Beach Fed. ID No. 65-0784647 <br /> <br />Address: 17070 Collins Avenue 11255 City/ State/Zip: Sunny Isles Beach. Fl. 33160 <br /> <br />Telephone: (30,'j 947-4440 <br /> <br />Fax: 005)947-4680 <br /> <br />E-mail:mikegrand@mindspring.com <br />