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2011-204A
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2011-204A
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Last modified
7/19/2019 12:07:28 PM
Creation date
10/1/2015 2:53:55 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
09/13/2011
Control Number
2011-204A
Agenda Item Number
12.I.1
Entity Name
Timothy Rose Contracting
Subject
Intersection Improvements Indian River Boulevard
Area
Indian River Boulevard and 17th St.
Project Number
1024
Bid Number
2011048
Supplemental fields
SmeadsoftID
10258
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D <br />A Corporation <br />Corporation Name: _ <br />State of Incorporation: <br />Type (General <br />(�' ire -- attach evidence <br />Name (typed or printed): <br />Title: <br />Attest <br />ssional, Service, Limited Liability): <br />to sign) <br />(SEAL) <br />�j (CORPORATE SEAL) <br />/ /` n <br />( <br />Signature of Corporate Secretary) <br />Business address: <br />Phone No.: `j `1,- /l Y7 e og <br />Date of Qualification to do business is <br />A Joint Venture <br />Joint Venture Name: <br />By: <br />FAX No.: <br />(Signature of joint venture partner -- attach evidence of authority to sign) <br />Name (typed or printed): <br />Title: <br />Business address: <br />Phone No.: <br />Joint Venture Name: <br />By: <br />FAX No.: <br />(Signature -- attach evidence of authority fo sign) <br />Name (typed or grin <br />Title: <br />Business address:; <br />Phone No.: <br />Phone and. <br />r <br />FAX No.: <br />AX Number, and Address for receipt of official communications: <br />(SEAL) <br />(SEAL) <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 -Bid Form REV 04-07.doc <br />00310-7 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\7024-17thStreet and IR <br />01 <br />vd Intersection\Admi m\Contract <br />Documents\00310 -Bid Form <br />REV 04-07.doc <br />
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