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SUBMITTED on October 14 , 2015 <br />State Contractor License No. CGC53314 <br />If Bidder is: <br />r rr lr .fc .... <br />An Individual <br />Name (typed or printed): NA <br />By: - (SEAL) <br />(Individual's signature) <br />Doing business as: <br />Business address: <br />Email: <br />Phone No.: FAX No.: <br />A Partnership <br />Partnership Name: NA (SEAL) <br />By: <br />(Signature of general partner -- attach evidence of authority to sign) <br />Name (typed or printed): <br />Business address: <br />Email: <br />Phone No: - FAX No . <br />A Corporation <br />Corporation Name: Ranger Construction Industries, Inc. <br />State of Incorporation: Florida <br />Type (Gener. ,- - , = o ess • :., j- ice, Limited Liability): General Business <br />(Signa ure — - • . = nce of authority to sign) <br />(SEAL) <br />Name (typed or printed): F. Scott Fowler <br />Title: Vice p -sident <br />Attest <br />Rick Fowler <br />(CORPORATE SEAL) <br />(Signature of Corporate -Secretary) Assistant Secretary <br />Business address: 4510 Glades Cutoff Road <br />Ft. Pierce. FL 34981 <br />Email: estimating@rangerconstruction.com <br />Phone No : (772) 464-6460 FAX No.: (772) 466-9559 <br />Date of Qualification to do business is June 8th, 1981 <br />00310 - Bid Form REV 0407 <br />- - 00310 - 5 <br />F:1Public Works\ENGINEERING DIVISION PROJECTS11304-CR 512 Resits {SCOPL125111 Ave to 1-95\Admimlbid documentstMastef Contract ooarments100310 - Bid Form <br />REV 04-07.doc <br />