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SUBMITTED on 20 <br /> 1� <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 : t C, kms, (' ��� I� ��r i c�a i t (1 C- (SEAL) <br /> State of Incorporation : F l o r i d <br /> Type (Gener I Bus ' , Professional , Service , Limited Liability) :�.p <br /> B <br /> (Si nature ch evidence of authority to sign) <br /> Name (typed or printed ) : WR ` >' r • �A L E <br /> Title : <br /> ( CORPORATE SEAL) <br /> Attest <br /> (Si nature of Corporate Secretary) <br /> Business address : <br /> r-fa plek.6 , rL <br /> Phone No . : FAX No . : <br /> QDate of Qualification to do business is 2 <br /> 00310 - Bid Form REV 0"Tdoc <br /> 00310 - 13 <br /> F.\Public WorkS\ENGINEERING DIVISION PROJECTS\0533-Oslo Rd Phase 11 (43rd Ave to 27th Ave)WdmirtMid documents\00310 Bid Form REV D4-07.doc <br />