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HomeMy WebLinkAbout0942 ~ ' i j . f E F , ~ ~ ' _ ' . _ . _ . . ~ THIS FINANGNG SiATEMEIlT is pnsMted 1e e Rfiy of6cer for fi1i~ ~ffp11~ ~p IN UAiFOl~ Co~~erciel Ced~: Matrriry doM (if oe 2~11-77 1. Wb~srls) (lwt llaN fint) e~d eddr~ssl~s) 2. S~arr~d ~wt~r(iN) esd oddressl~s) fw fil:N Officer (DoN. TiM. lM~Mr, a~d iilip O(fw) ~ GOULD, M.D. Martia G. ' P. o. Box 3390 - SUN BANK OF ST. LUCIE CO ~ f Eo REC R o P. O. BOx 8 s~iuc~c :;auM~ ~u. ` ~ Fort Pierce, Florida 33450 1 1 2 SOUTH SECOND STREET ~a~E~ ~Q~T~AS ` ~ CLEfiR C.-:~Wi COURT ~ FORT PIERCE, FLORIDA 33451 Pf~~R~ y~R~F~EO..~.~~ ~ 1. T~is N~a~dM staM~t conn IM tslto~i~~ h~ws (a ite~i) e/ wew~h: ~ ~O . ~ Serial ~ Instrument Model # Serial # Instrument ' 912461 Esophagoscope EF2 Colonofibersco e 4 ; 910426 Gastroscope GFBK 310740 " = 100625 Duodenoscope JFB 912902 " s. ",s..^«~•? s«~..~ ra.,~ a.e ~e~..,.~..~ ' 410465 Gastrointestinal GIFR 311051 Lecturescope - ~ (Fiberscope) 344291 Photographic paratus ~ ~ e. ts...c.r.a vorhfsl. • s:~.e~.nlt) evw«s b.~o.. .~or.. ~rer sro.ps r.a.l.ee br O~P~« 201, f~erias See:vws, ~ ii ary. ~on 6Nw y1x~d ew IM pro~itwry imhv~cnh s~nd iu~bp, anA rill p~ plocW e~ awr odllipiql ond si~ilw ~M ~ ietMr~~w11M1 Ee t0 t~cwed. VV.l.~5~ Tyii sM»~t is ~I~d viHwt tM d~MK's siYwhin ~o penc~l a~riy i~Nrtsf i~ celbhral. (p~k Q i/ w] ~ ~ ? Akwd) s~bj~cf h~ wcHiy iMere~f ie aneMer jrtisd:diow oMw it nas breq~l i~lo MFt 1bN. ~ ~ ?~~ic? is proc~s e/ iM erisiwal c~lbNrol diwibed ~bo.~ iw vakY a sec~rih i~M~s~ ~~s p~rt~ct~d. ~ fi i aeck Q i( u•snd- ? hx~ et ColbNrd ere olw to~ered. ??redvd~ ef Ce1laNrol ae olso co.~nd. /10. e( odditiowel Sbe/s p~sewt~d: d a ~ ~ f1id St. Lucie Co ~ ~ ~ ~ SlM BANK OF 8T. WCtE COUNTY ~ ~ .r• , ~ Siw~hrnl~) ef Deblx(sl ' S~s~et (s) e~ Src~r~A I ) ~ STANDARD FOltM - FORM UCG-1 6OOK ~ PACE ~ F Apprs~ed A1 Ric?ard (Oicll SMM. SarHory ~1 SfoN. Sfoh o( Florida ~ F;!t,,.; r_;_. -A~DFte~}IWI ~'~L ~4 ?a _~_r._ . . _ . . . . ."~~.Y.~ P.u