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SUBMITTED on , 20.0f <br />State Contractor License No. 0.cc;L4 IZT11/ <br />If Bidder is: <br />An Individual <br />Name (typed or printed): <br />By: <br />(Individual's signature) <br />Doing business as: <br />Business address: <br />Phone No.: <br />A Partnership <br />Partnership Name: <br />By: <br />FAX No.: <br />(Signature of general partner -- attach evidence of authority to sign) <br />Name (typed or printed): <br />Business address: <br />Phone No.: <br />A Corporation <br />Corporation Name: <br />State of Incorporatic <br />Type (General Business, <br />FAX No.: <br />Byk/ <br />(Signature <br />Name (typed <br />Title: <br />Attest <br />, Service, Limited Liability): <br />evidence of authority to sign) <br />printed): <br />(Signature of Corporate Secretary) <br />Business address: <br />(SEAL) <br />(SEAL) <br />(SEAL) <br />(CORPORATE SEAL) <br />Phone No.: <br />FAX No.: :z7.� 778' aR6? 1� <br />Date of Qualification to do business is 0 e- un 45 sa <br />00310- 4 <br />FAEngineering\Petition Paving\0522 1st Rd. from 32nd Ave. to 35th Ave\Bid Documents\00310 - Bid Form. doc <br />