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UNIVERSAL ENGINEERING SCIENCES, INC.
1818 7th Ave. North Unit 1
Lake Worth, FL 33461
Phone: 561-540-6200 Fax: 561-540-6242
E-mail: WPBBID@universalengineering.com
Alternative Services Agreement
Project: Creekside Plat #4 Lot 38 at 3342 Trinity Circle, Fort Pierce
Private Provider Firm: Universal Engineering Sciences
Private Provider Name: Richard Hoaglin
Address: 820 Brevard Avenue, Rockledge, Florida 32955
Phone: (321)638-0808 Fax: (321)638-0976
Names, License/Certificate Numbers, and License description of provider and duly authorized agents who will be providing
services for this project.
Name:
License/Certificate No.:
License/Certificate Type:
Don Determan
BN# 4688
Inspector — Building (1 and 2 family), Plumbing
Josean Duprey
BN# 7330 PX# 4208
Plan Review — Building, Inspector - Building
Richard Jefferson
BN# 1164 PX#513
Plan Review — All Trades, Inspector — All Trades
Don Green
BN# 7301
Inspector —Building, Electrical
Carl Peterson
BN# 5555 PX# 2764
Plan Review— Residential, Inspector— MEP,
Building
As the private inspection services provider for this project, I have read and agree to be bound to the provisions of State
Statute 553.791. 1 further agree and understand that only the above listed personnel may perform inspections on this
project and that if for any reason the inspection personnel should chan son listed above should discontinue
to quality as a duly authorized agent, you will be notified in writi imrpediately/')
Representative Name:
Signature
State of Florida, County of Brevard
Sworn to (or affirmed) and subscribed before me this 28th day of October , 2020, by Richard E Hoaglin,
who is personally known to me.
Jennifer J Fuhrer
Printed name of Notary
Notary Public Stamp: JennibrJw=Fuhmr
Notary Public
0 —State of Florida
Comm# HH035937
NCE 19 Expires 8/24/2024
11 FIL..;i