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SUBMITTED on 120 <br /> State Contractor License No . <br /> If Bidder is : <br /> An Individual <br /> Name (typed or printed) : <br /> By: (SEAL) <br /> (Individual's signature) <br /> Doing business as : <br /> Business address : <br /> Phone No . : FAX No . : <br /> A Partnership <br /> Partnership Name : (SEAL) <br /> By: <br /> (Signature of general partner -- attach evidence of authority to sign) <br /> Name (typed or printed ) : <br /> Business address : <br /> Phone No . : FAX No . : <br /> A Corporation <br /> Corporation Name : In e. (SEAL) <br /> State of Incorporation : Gori zf rL� <br /> Type (General Business , Professional , Service, Limited Liability) : <br /> By <br /> (Signature — att h evidence of authoritytosign) <br /> Name (typed o printed ) : ._.S rn hj1 d Mee) i - 11 <br /> Title : C� ntV rr I— i� m it r s+1 ri M r' <br /> (CORPORATE SEAL) <br /> Attest <br /> — <br /> (Signature of Corporate Secretary) <br /> Business address : % IS' sgneher- icri /Y .& d.o . S, i i L 0 I <br /> Phone No . : 77 D- 77err 7FAX No . : :z7 ..�k 778' a96? �- <br /> Date of Qualification to do business is 0 c un ja sa .1 g g� <br /> 00310 - 4 <br /> FAEngineering\Petition Paving\0522 1st Rd. from 32nd Ave. to 35th Ave\Bid Documents\00310 - Bid Form. doc <br />