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<br />) <br /> <br />APPLICATION FOR REGISTRATION OF FICTITIOUS NAME <br />REGISTRA TION# G11 000014388 <br /> <br />Fictitious Name to be Registered: CHEN MOORE AND ASSOCIATES <br /> <br />Mailing Address of Business: <br /> <br />500 W. CYPRESS CREEK ROAD <br />SUITE 410 <br />FT. LAUDERDALE, FL 33309 <br /> <br />Florida County of Principal Place of Business: BROWARD <br />FEI Number: <br /> <br />FILED <br />Feb 07,2011 <br />Secretary of State <br /> <br />Owner(s) of Fictitious Name: <br /> <br />CHEN AND ASSOCIATES CONSULTING ENGINEERS, INC. <br />500 W. CYPRESS CREEK ROAD, #410 <br />FT. LAUDERDALE, FL 33309 US <br />Florida Document Number: J41454 <br />FEI Number: 59-2739866 <br /> <br />\ <br /> <br />, <br /> <br />I the undersigned, being an owner in the above fictitious name, certify that the information indicated on this form is true and <br />accurate. I further certify that the fictitious name to be registered has been advertised at least once in a newspaper as defined <br />in Chapter 50, Florida Statutes, in the county where the principal place of business is located. I understand that the electronic <br />signature below shall have the same legal effect as if made under oath and I am aware that false information submitted in a <br />document to the Department of State constitutes a third degree felony as provided for in s. 817.155, Florida Statutes. <br /> <br />PETER MOORE <br />Electronic Signature(s) <br /> <br />02107/2011 <br />Date <br /> <br />Certificate of Status Requested ( ) <br /> <br />Certified Copy Requested ( ) <br /> <br />