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CONTRACTOR AUTHORIZATION FORM <br /> STATE LICENSE NO.: EC13001287 <br /> PRINT QUALIFIER'S NAME: DONALD WARNER <br /> DON WARNER ELECTRIC <br /> BUSINESS NAME: <br /> I authorize the following individuals to sign for and obtain permits: (Please print names clearly.) <br /> DEBORAH PLATTHY JEANETTE BALOUGH <br /> STACY GRAVES JORDAN MILLER <br /> ARIFI- Blll_LINGTON STEPHANIE COFFEY <br /> JACOB HODGES <br /> Signature of Qualifier: Date: 11/01/2018 <br /> State of Florida <br /> County of 11/01/2018 <br /> Sworn to and subscribed before this day <br /> -a,,V�- 6 &��V <br /> Notart Publi(YStatd of Florida <br /> (Stamp) <br /> My commission expires <br /> "N Notary Publio Stete of Florida <br /> Timothy Coffey <br /> My Commission,GG 246671 <br /> aw E.pires 0 811 5/2 0 22 <br />