Laserfiche WebLink
A Corporation <br /> Corporation Name : t L� C�. �- : (SEAL ) <br /> State of Incorporation : �` �v� <.. (� , <br /> F <br /> Type ( General Busmesfessional , Service , Limited Liability) :IF <br /> By : _. <br /> (Signatur - attach evidence of authority to sign) <br /> # H <br /> a <br /> Name (typed or printed ) : — Fit Vy 1,1 L�, 5 � 'tN <br /> Title : ace' S ' <br /> i � <br /> Attest _ �ra-v� �� �_ <br /> ( CORPORATE SEAL) s <br /> (Signature of Corporate Secretary) <br /> Business ddress : _ I O (ic) <br /> Phone No. : 1717 ,1 - S(L - �f cc> FAX No . : _ `l 7 -5G- q- - I ORR , <br /> Date of Qualification to do business is <br /> p <br /> EY <br /> A Joint Venture <br /> Joint Venture Name : <br /> (SEAL ) <br /> By: t i <br /> (Signature of joint venture partner -- attach evidence of authority to sign) <br /> Name (typed or printed ) : a ,J <br /> u <br /> i` <br /> N ; <br /> Title : <br /> z ' <br /> Business address : <br /> Phone No . : IF <br /> FAX No . <br /> Joint Venture Name : <br /> (SEAL) <br /> By: <br /> (Signature — attach evidence of authority to sign) <br /> Name (typed or printed ) : <br /> Title : r <br /> Business address - <br /> Phone No . . <br /> I � <br /> FAX No . : <br /> VIII l <br /> Phone and., AX Number, and Address for receipt of official communications : <br /> it <br /> t <br /> IF <br /> ( Each joint venturor must sign . The manner of signing for each individual , partnership , and <br /> corporation that is a party to the joint venture should be in the manner indicated above . ) <br /> 00310 -8 <br /> FAPublic Works\ENGINEERING DIVISION PROJECTS\0745-Indian River Blvd Sidewalk Imp. Pro! 12th_17th St. (LAP)\Admim\bid documents\00310 - Bid Form.doc <br /> i <br />