REQUIREMENT TO BE COMPLETED WITH THE CONTRACTOR (Item 6a) A. CATEGORIES OF AUTHORIZED ENERGY SERVICES ANTIDOTE MANAGEMENT SERVICES LLC ATTN CARMICHAEL L. BROADWAY 633 W. NORTH COLLEGE PKWY ROAD ARLINGTON TX 76001 ATTN KENDALL C KENDALL 955 E. CAMPBELL ROAD ATLANTA GA 30322 ATTN DALE A MARSHES 955 WEST PECAN ROAD ATLANTA GA 30322 ATTN MELISSA K MARSHES 955 E. COBB ROAD ATLANTA GA 30322 ATTN NICK M MARSHES 955 E. COLBERT ROAD ATLANTA GA 30322 11. ADDITIONAL CATEGORIES OF AUTHORIZED ENERGY SERVICES COUNT Y RANGE OF AUTHORIZED ENERGY SERVICES FOR CIRCULATION (US) NUMBER OF CATEGORY A. APPLICATIONS FOR CATEGORIES (Item 6b) B. FORM CERTIFICATION AND OTHER AUTHORIZED ENERGY SERVICES CERTIFICATION AND OTHER AUTHORIZED ENERGY SERVICES FORM 4(C) ANTIDOTE MANAGEMENT SERVICES LLC RULES AND REGULATIONS OF ANTIDOTE MANAGEMENT SERVICES LLC ANTIDOTE MANAGEMENT SERVICES PARTIES COUNTY AMOUNT BEE ANTIDOTES MANAGEMENT SERVICES P.O. BOX 73 BOISE ID 837290001 C. ADDITIONAL CATEGORIES OF AUTHORIZED ENERGY SERVICES COUNTIES AND SUBSIDIES OF ANTIDOTES MANAGEMENT SERVICES RULES AND REGULATIONS ANTIDOTES MANAGEMENT SERVICES PARTIES COUNTY AMOUNTS CITY OF ARLINGTON BEE ANTIDOTES MANAGEMENT SERVICES P.O. BOX 73 BOISE ID 837290001 D. ADDITIONAL CATEGORIES OF AUTHORIZED ENERGY SERVICES COUNTIES AND SUBSIDIES OF ARLINGTON BEE ANTIDOTES MANAGEMENT SERVICES P.O. BOX 73 BOISE ID 837290001 E. OTHER CATEGORIES OF AUTHORIZED ENERGY SERVICES OTHER APPLICATIONS CATEGORIES DATE OF APPLICATION (Item 6c) 11.
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NOT SPECIFIED /OTHER 1. CONTRACT ID CODE AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT PAGE OF PAGES 1 2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 006 06/09/2009 02801 6. ISSUED BY CODE 4.
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