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<br />City of Sunny Isles Beach |Request for Qualifications No. 16-06-01 16 <br /> <br />COVER PAGE <br /> <br /> <br /> <br />Legal Name of Firm ______________________________________________________________________ <br /> <br />DBA, if any _____________________________________________________________________________ <br /> <br />FEIN ___________________________________ <br /> <br />Mailing Address _________________________________________________________________________ <br /> <br />City, State, Zip Code _____________________________________________________________________ <br /> <br />Contact Name _______________________________________________________ <br /> <br />Title _______________________________________________________________ <br /> <br />Contact Email Address ________________________________________________ <br /> <br />Contact Telephone Number ____________________________________________ <br /> <br /> <br />1. I hereby certify that I am authorized to act on behalf of the Firm and that all statements made in this <br />document are true and correct to the best of my knowledge. <br />2. By submitting a response, the Firm certifies that the Firm has fully read and understands the RFQ. <br />3. Firm understands and agrees to be bound by the conditions in the RFQ and shall conform to all the <br />requirements. <br />4. Firm proposes and agrees, if awarded a contract, to enter into an agreement with the City of Sunny <br />Isles Beach to perform and furnish consulting services. <br /> <br /> <br />Authorized Signature _________________________________________________ <br /> <br /> <br />Print Name _________________________________________________________ <br /> <br /> <br />Title _______________________________________________________________ <br /> <br /> <br />Date ______________________________________________________________ <br /> <br /> <br />Land & Sea Surveying Concepts, Inc. <br />020540634 <br />1605 Chase Hammock Road <br />Merritt Island, Florida,32953 <br />Tim Carlile <br />President <br />TC5170@aol.com <br />321-454-6310 <br />Tim Carlile <br />President <br />6/24/2016