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SUBMITTED on . 120 <br />State Contractor License No. <br />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: (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 />I <br />Business address: <br />Phone No.:' FAX No.: <br />Email: <br />Date of Qualification to do business is <br />00310-600310 . — Bid Form REV 0407 <br />F: I'Me WorkMENGINEERING DIVISION PROJECTS11736 IRC Health Department Roof Replacement Projectll-Admin%Bid DocumentsWasler Contract Documents\00310 - Bid <br />Form REV.04-07.doo <br />A Joint Venture <br />.Joint Venture Name: (SEAL) <br />