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<br />N <br /> <br />w <br /> <br /> <br />ill Business to Secure Yours <br /> <br />s <br /> <br />CONTRACTOR AUTHORIZATION FORM <br />COMTRACTOIrt LlCENSb CBC1251i'94 <br /> <br />FROM: <br /> <br />David C. Bearce <br />Engage Technologies, lnc, <br />8419 Sunstate Street <br />Tampa, Florida 33634 <br /> <br />lherebyauthorizethe c..1-r'l O~ Z~pf.tit2HII.LS '8Vll.Dlt..Ko -r:>2r1'". to issue permits in the name of <br />Engage Technologies, lnc, signed by Zachary Krueger, I certify that the above authorized person is employed by the firm <br /> <br />and understand that I am fully responsible and liable for all acts performed under said permits. <br /> <br />o,ln::,/~ <br /> <br />Date <br /> <br />~ <br /> <br />~gn,1ure of Q>>,lificr <br /> <br />- <br /> <br />Sta te of: <br /> <br />tLoll.IQI:\ <br />1/, LLS&lbJ'-H <br /> <br /> <br />ed Agent <br /> <br />County of: <br /> <br />Subscribed and sworn to before me this ,;) S:t.J:> day of <br /> <br />j~R~ <br /> <br />.jULj <br /> <br />. 2014 <br /> <br />Commission Expires: <br /> <br />~-/3-0 7 <br /> <br />Notary Public <br /> <br />r...H................. ... .........................1 <br />: ~''''~ DEANNA L PARKETON . <br />: Iftt) Commiaaion.D00200724 i <br />i ~~~~ ~ 4/1312007 : <br />! "'tP.r.f\: Bonded thrOugh i <br />: (800-432-4254) Florida Neary Assn,. Inc. : <br />.. .... II ....... ............ ........................... <br />