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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 /> Email: <br /> A Partnership <br /> Partnership Name: Proctor Cons coon Company,LLC- (SEAL) <br /> By, <br /> (Signature of general partner=attach evidence of authority to sign) <br /> Name (typed or printed): Donald C.Proctor <br /> Business address: 2050 VS Hwy 1. to 200,Vero Beach-FL 32960 <br /> Phone No.: FAX No.: 772.234.8 198 <br /> Email: dtolliyeTapmctormtom <br /> A Corporation <br /> Corporation Name. (SEAL) <br /> State of Incorporation: <br /> Type (General Business, Professional, Service, Limited Liability): <br /> By: <br /> (Signature—,attach evidence of authority to sign) <br /> Name (typed or printed):. <br /> Title: <br /> (CORPORATE SEAL) <br /> Attest, <br /> (Signature of Corporate Secretary) <br /> Business address: . <br /> Phone No.: FAX No.: <br /> Email: <br /> Date of Qualification to do business is <br /> 00310-5 00316 Bid Form REV 04-07 <br /> F;XPubIIcWorkS%ENGINEERING DIVISION PROJECTS%1213C IRC Shooting Range Hunter Eduction ClassroomXAdminlbid documentsWaster Contract Docurnents100310-Bid <br /> Form REV 04-0.doc <br />