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<br />Individual to Contact: <br /> <br />Sheila Fulmer <br /> <br />Phone Number: <br /> <br />803-359-8107 <br /> <br />Name: Brevard County EMA <br /> <br />Address: 1746 Cedar Street <br /> <br />Rockledge, FL 32955 <br /> <br />Starting Date: 2005 (last contract) <br /> <br />Number Years: 10 <br /> <br />Individual to Contact: Rav Gann <br /> <br />Phone Number: 321-637-6670 <br /> <br />I certify that the information supplied herein (including all pages attached) is correct and that <br />neither the applicant nor any person (or concern) in any connection with the applicant as a <br />principal or officer, so far as is know, is now barred or otherwise declared ineligible by any <br />public agency from bidding for furnishing materials, supplies or services to any agency thereof. <br /> <br /> <br />Sign <br /> <br />of person authorized to sign this application <br /> <br />J. Scott Eddlemon, vp <br />Name and Title of person signing (please type or print) <br /> <br />The undersigned hereby certifies the bidder has read the terms of this bid document, and is <br />authorized to bind the firm to the information herein set forth. <br /> <br />Date: <br /> <br />4_10_0F. <br /> <br />Pulcir. Inc. <br />Name of Firm <br /> <br />*NOTE: Bid check list (see form 2 of 5, page 15) to be included with this bid item. <br /> <br /> <br />tt Eddlemon, VP <br /> <br />19 <br /> <br />F-ICl <br />