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UNIVERSAL ENGINEERING SCIENCES, INC. <br /> .`IN9802 Palm River Rd. <br /> Tampa, FL 33619 <br /> Phone: 813-740-8506 Fax: 813-740-8706 <br /> E-mail: TampaBID@UniversalEngineering.com <br /> Alternative Inspection Services Agreement <br /> Project: PT Solutions—Zephyrhills—7403 Gall Blvd, Zephyrhills FL 33541 <br /> Provider Firm: Universal Engineerinq Sciences, Inc. <br /> Private Provider Name: Mark K Hardy P. E. <br /> Address: 9802 Palm River Road, Tampa, FL 33619 <br /> Phone: 813-740-8506 Fax: 813-740-8706 <br /> Names, License/Certificate Numbers, and License description of provider and duly authorized agents <br /> who will be providing services for this project. <br /> Name: License/Certificate No.: License/Certificate Type: <br /> Mark Israel 47070 Professional Engineer <br /> Mark K Hardy 57233 Professional Engineer <br /> George Dixon BN1008 Standard Inspector <br /> Daniel Sirois BN6668 Standard Inspector <br /> Kenneth Scheitler BN2552 Standard Inspector <br /> Jeffrey Waterman BN7133 Standard Inspector <br /> Frank Ross BN4330 Standard Inspector <br /> Anthony Pino BN2994 Standard Inspector <br /> Gregory Yantorno BN3290 Standard Inspector <br /> Steve Lee BN5627 Standard Inspector <br /> Jon Betcher BN5128 Standard Inspector <br /> Rene L. Pepin BN701 Standard Inspector <br /> Kevin Eichelberger BN7010 Standard Inspector <br /> Robert Bott BN2297 Standard Inspector <br /> As the private inspection services provider for this project, I have read and agree to be bound to the provisions <br /> of State Statute 553.791. 1 further agree and understand that only the above listed personnel erform <br /> inspections on this project and that if for any reason the inspection personnel should chan��)�bw'f �/� �n <br /> listed above should discontinue to quality as a duly authorized agent,you will be notified Q ••�., Ii���/' <br /> ° <br /> Printed name of Alternative Provider: Mark K Hardy, P. E. `vs <br /> Signatu of Altgrnalve i er at? <br /> State of Florida, County of Hillsborough, ,.�� _ ,� ; <br /> �1d'a5��fyPti .jr � • <br /> ,�° 'sc p�f� STATE OF o <br /> `, �sj•- °° 18Mar rd , who is <br /> Sworn to or affirmed and subscribed before t '" '," a of e ° , <br /> � �p {b Y <br /> ° s • OF�ID O <br /> personally known to me. 4�; ao4'; s �i ••.. ..•• <br /> Q o "•�b M; ��iii SSI ALONG.., <br /> Diane Rivera oF�s2Z74 �11 ,!r► 1�` <br /> a��;F�nihtu�•• • Q'� . <br /> Printed name of Notary ;C •.•.• °oQvhgn re of Notary <br /> Notary Public Stamp: <br /> iso1'rAT aO�� `��a <br />