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Document A305

-1986

Contractor's Qualification Statement

The Undersigned certifies under oath that the information provided herein is true and

sufficiently complete so as not to be misleading.

SUBMITTED TO:

M

r. Evan Rosenblatt

PE

BB

Enterprises

7900 Glades Road

/

Suite 600

B

oca Raton, FL 33434

SUBMITTED BY:

J. Raymond Construction Corp.

NAME:

Paul Graham

ADDRESS:

465 West Warren Avenue

Longwood, FL 32750

Phone 407-862-6966

Fax 407-571-3596

PRINCIPAL OFFICE:

Same as above.

[ X

] Corporation

[

J Partnership

[

J Individual

J

Joint Venture

J Other

NAME OF PROJECT

(ifapplicable):

TYPE OF WORK

(file separate form for each Classification ofWork):

X

] General Construction

]HVAC

J

Electrical

J Plumbing

]Other (please specify)

§ 1. ORGANIZATION

§ 1.1

How many years has your organization been in business as a Contractor?

26

§

1.2

How many years has your organization been in business under its present business

name? 26

§

1.2.1

Under what other or former names has your organization operated?

ADDITIONS AND DELETIONS:

The author of this document has

added information needed for its

completion. The author may also

have revised the text of the original

AIA standard form. An

Additions and

Deletions Report

that notes added

information as well as revisions to

the standard form text is available

from the author and should be

reviewed. A vertical line in the left

margin of this document indicates

where the author has added

necessary information and where

the author has added to or deleted

from the original AIA text.

This document has important legal

consequences. Consultation with an

attorney is encouraged with respect

to its completion or modification.

This form is approved and

recommended by the American

Institute of Architects (AIA) and The

Associated General Contractors of

America (AGC) for use in evaluating

the qualifications of contractors. No

endorsement of the submitting party

or verification of the information is

made by AIA or AGC.

AIA Document A305

-1986. Copyright©1964, 1969, 1979 and 1986 by The American Institute of Architects. All rights reserved.

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n

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.

Unauthor

i

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