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HomeMy WebLinkAboutChange of Contractor ' IDII�IG&ZUl'm''C-x } � U , i 23t VRRIIIIA A V IEJR. 3 � Com,FL 34 4424553 FA '46 1518 I C;HAANG OF CQNTRA GTO►1IBCOlRACTUR aR _A_OF I LL 'EFsFZrT 4NE OF 1E Ff)LIAWINr �- H NGE U 'IGDli1 RAiQTT Change o Contxactar ,s to be swgaed and natartzed by the ro e,vyp��rner,! and a Healy contractor 'A MO . permit A anew permit ap,��icati`c�� must£alsa be com�leted,wr�x�ev� - • c©zit ctor� n€cr %tno>a and signature A new I o€ice o oniinea�ceiineotmusts e��, > the neva can ctt 's r ame for pb'�t ties g ea er than -0.O ( ?,5OO f Al Chan zge-oot}� A m a de ec��y' t>usst'FZ : � ;pnor # ` cbimencin' vuork Thee>as 4:"$ 5Q 04 ffor te �tau e,of'Cii»traetflr:,- g any . g r C MNGE+DF SUIiCQNTI AC'T'UR-Sutico>xtraetar ck t ges ale to 6e_campleted by the general ca&actar:.,' The4new subcoautsatctor aaaaast1 antra S,tacratcacta Agree#nent;•Farrn:There a<s Q 00 few fair the.C' iaange aSuT -> 6 C�oaoixact+par. I �IN ELLATfQI Q PE17;MLT The cancellation of a pe mi is acceptable oily><f ha vv+ zk has beery dank: �'�. Cancellation uf,peruut%=�s=ter be signed„axxd natar;�ed�b�'bath the.ctwnerz��cd q�at�'�er of”recor;�,There is uo;fee ftr�` caa'tcellat%an of _.. _ Dame ��� :; �- Peirm>d N'umber:e�..`'��:.C7�� - S�t�.Aadaress _ NJ 1•. �+ State;Lrcei>se SLC Lxcetase '4rg>tnal GC,subcontrae�tor ar ozvxterJ.buldec' -. - . w. � SLG License _ I S °l�1ew GC,subcontractor; Reasonfor Caucellattan. - . Tbe`undets " ezi does heref y agree to rude N�and hold"hartnTess�t�Luc a County,ats officers,agents aasd em layees from all costs damages artsirig,tiom any and all claims of action fox any reasoz>,which tna} a restilf of kl wchaupe-of on ,. --or; eancellatZoaa£�ermEif:A,perinit c enot be ca�ot has been,pe ormed. a 5(zNT(JRE)a baK(arawrielinilcler STGI�IATUR ,CxEAtERAI GC}2a 1 (arner C,as2pphcabTe �}tI�7T NAMEf ' °F'ILiI�'I'Nt� M - _ r. � • StateafFIarttf�,tsounry•afSLLatcie unty Statea�PliAda Catuitya q ,Luety The faot>r3ng;mstumeak was aclsnowTedgedlh fore me this Tlie fnitowmg att was wYedg«3 Uefae;me flus + 24 b _day Qf tttm�+ �- wha u,personalig7uayyn la;u7e � "'uiho pecsonatlytata�yu 4iq Zo asp.>" HS""atuYe�ofN` JD�,tc: '" Sigaa#ureo£:1+Iotary,: ._ date` ' NIGQL BRATTQN n flu Nle®L@RA7�Oa� :Ret+isdd �T$taCfl oP Florida�LVotary Publ% , State of Fl�sr�da-Nc12a Pubifc ; rVrr3ta sappy# G 22&22$.. :4 Comnfssws�#!Gf 2! 228 ; Comrnlss74rs�X lyes �a•t�.8�i.2Q22 � .,_.