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If Bidder is: <br />An Individual <br />Name (typed or printed): <br />By: <br />(Individual's signature) <br />Doing business as: <br />Business address: <br />Phone No.: <br />Email: <br />A Partnership <br />Partnership Name: <br />FAX No.: <br />By: <br />(Signature of general partner -- attach evidence of authority to sign) <br />Name (typed or printed): <br />Business address: <br />Phone No.: <br />Email: <br />FAX No.: <br />(SEAL) <br />(SEAL) <br />A Corporation <br />Corporation Name: W&1 Construction Corp. (SEAL) <br />State of Incorporation: Florida <br />Type (General Business, Professional, Service, Limited Liability): General Business <br />By: --- <br />(Signature -- <br />Name (typed or printed): <br />Title: <,- Vice PrWdent <br />or aurnonry to signs <br />Erik Costin <br />(CORPORATE SEAL) <br />Attest I Derosia <br />(Signa ure of C rporate Secretary) <br />Business a 1038 Harvin Way, Suite 120 <br />Rockledge, FL 32955 <br />Phone No.: g21 6:t? 766r) FAX No.: 121.6:19 S927 <br />Email: arikr@wirnnctrurtion_rom <br />Date of Qualification to do business is March 17, 1965 <br />A Joint Venture <br />00310 - Bid Form REV 04-07 <br />00310-7 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1744 Sebastian Comers\1-Admin0d Documents\MasterContract\Master Contract Documents\00310 - Bid Form REV <br />04-07.doc <br />