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TOSHIBA <br />Leading Innovation ?» <br />PROPOSER'S QUALIFICATION STATEMENT <br />6401 Nob Hill Road <br />Tamarac, FL 33321 <br />In order to properly evaluate the proposal submittals, Proposers are expected to complete the <br />questionnaire and include the following documentation. By attesting to this submittal, Proposer <br />guarantees the truth and accuracy of all statements and answers herein contained. <br />SUBMITTED TO: City of Coconut Creek <br />Purchasing Division <br />4800 West Copans Road <br />Coconut Creek, FL 33063 <br />Submitted By: Toshiba Business Solutions <br />Name: Matt Barnes <br />Address: 6401 Nob Hill Road <br />City, State, Zip Tamarac, FL 33321 <br />Telephone No. 954 -428 -1300 <br />Fax No. 954556 -8575 <br />Check One <br />X Corporation <br />D Partnership <br />D Individual <br />D Other <br />1. State the true, exact, correct and complete name of the partnership, corporation, trade or fictitious <br />name under which you do business and the address of the place of business. <br />The correct name of the Proposer is: CopvCo Inc dlbla Toshiba Business Solutions <br />The address of the principal.place of business is: 6401 Nob Hill Rd., Tamarac, FL 33321 <br />2. If Proposer is a corporation, answer the following: <br />a. Date of Incorporation: <br />b. State of Incorporation: Florida <br />c. President's Name: Matt Barnes <br />d. Vice President's Name: Brian Curry <br />e. Secretary's Name: NIA <br />f. Treasurer's Name: Mike Torcasso <br />g. Name and Address of Resident Agent: NIA <br />3. If Proposer is an individual or a partnership, answer the following: <br />a. Date of Organization: NIA <br />b. Name, Address and.Ownership Units of all Partners: NIA <br />c. State whether general or limited partnership NIA <br />Toshiba's Recommendations for The City of Coconut Creek's RFP Jar Managed Print SeMces, 12 -01 -10-10 <br />Page 30 of 42 <br />