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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: (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 /> Email: <br /> A Corporation <br /> Corporation Name: Community Asphalt,Corp. (SEAL) <br /> State of Incorporation: FL <br /> Type(Genera! Businet,,:�Ilp <br /> ssional, Service, Limited Liability): General Business <br /> By: q709LA <br /> (Signature—attach eykence k, <br /> authority to sign) <br /> Name(typed or printed): Manuel Aguiar <br /> Title: Vice President <br /> �1 <br /> Attest (CORPORATE SEAL.) - <br /> L��%tiyL�t�Q�l� /:� w r���l <br /> (Signa re of Cor rate Secretary <br /> Business address: 2975 Industrial Blvd <br /> Vero Beach,FL 32967 <br /> Phone No.: (772)770-3771 FAX No.: (772)770-3707 <br /> Email: jbickford@cacorp.net <br /> Date of Qualification to do business is 9/22/1980 <br /> A Joint Venture <br /> Joint Venture Name: (SEAL) <br /> By: <br /> (Signature of joint venture partner—attach evidence of authority to sign) <br /> 00310-Bid Forth REV 04-07 <br /> 00310-6 <br /> F'V'ublic Woft%ENGINEERING DIVISION PROJECTSMig Rand Island Facility Pavingll-Admin\bid documents%Master Contract DocumenlsW0310-Bid Form REV 04. <br /> 07.doo <br />