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Secretary <br />CITY OF SUNNY ISLES BEACH <br />PARKS /MEDIANS/RIGHT -OF -WAY MAINTENANCE <br />(CORPORATE SEAL) <br />IN THE PRESENCE OF: <br />State of _ <br />County of <br />On this, the day of _ <br />Notary Public of the State of <br />(name of corporate officer), <br />corporation), a <br />corporation. <br />By: <br />(Signature and Title) <br />(Type Name & Title signed above) <br />INSURANCE COMPANY: <br />Address: <br />Agent and Attorney -in -Fact <br />(Street) <br />(City /State /Zip Code) <br />Telephone No.: ( <br />, 19 , before me, the undersigned <br />the foregoing instrument was acknowledged by <br />(title), of (name of <br />(state of corporation) corporation, on behalf of the <br />BIDDERS NAME: <br />COMPANY NAME: <br />