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I <br /> Aft <br /> WDDepartmegtti�nt ashin �n State <br /> Transportation Authorized Signatures <br /> List the name and title of those individuals in your organization who are authorized to execute proposals, <br /> IIcontracts, bonds and other documents and/or instruments on behalf of the organization. Specify if more <br /> than one signature is required. <br /> NOTE: 5i 4 nature must ail pear next to nMIIIIIIIIIIII <br /> Name(Typed) Signature / Title <br /> I <br /> DRPcC \'kPR+r-A, Coos"rRVcnON MANACaER <br /> Name ed T Signat Title <br /> • <br /> (Typed)) /J <br /> IName(Typed) Signature Title <br /> IName(Typed) Signature Title <br /> Name(Typed) Signature Title <br /> IName(Typed) Signature Title <br /> IName(Typed) Signature Title <br /> Name(Typed) Signature Title <br /> Name(Typed) Signature Title <br /> IName(Typed) Signature Title <br /> IName(Typed) Signature Title <br /> IThe undersigned, being duly sworn, deposes and says that the foregoing is a true statement of facts <br /> concerning the individual, corpration, co-partnership or joint venture herein named, as of the date indicated: <br /> Name of Firm-Be Exact <br /> ICr. ?AvIN C71 1 L.L.C. <br /> Sworn to before me this <br /> I day of MO,Ar CAA, , 22_ <br /> I tli:;.°1% <br /> ____7/62-----' <br /> 40 Notary Public Autho,rpd,S'1R ture(s) <br /> ' _ ` SEAL <br /> _ '° OTA R Y `�c'�' <br /> PUBLIC ��'' ? P.00MPNy <br /> Number •'.4C, .; '...4 r�E 0C& .`. <br /> I <br /> �? <br /> DOT Form 420-007 EF �Iiil41,,,,,11010 ` <br /> Revised 10/02 <br />