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Ouestionnaire Contractor's Name: Principal Office Address: Individual Partnership Corporation (Circle One) If a Corporation. answer this: When incorporated: In what State: If a Foreien Corporation: Date of Registration with Florida Secretary of State: Name of Resident Agent: Address of Resident Agent: President's Name: Vice-President's Name: Treasurer's Name: Members of Board of Directors: If a Partnership: Date of Organization: Date of Limited Partnership: Name and Address of Each Partner: Name Address Attachment "C" 16