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SUBMITTED on March 28 , 20 19. <br />State Contractor License No. CGC1507554 <br />If Bidder is: <br />An Individual <br />Name (typed or printed): n/a <br />By: n/a <br />(Individual's signature) <br />Doing business a as: n/a <br />Business address: n/a <br />Phone No.: n/a FAX No.: n/a <br />Email: n/a <br />(SEAL) <br />A Partnership <br />Partnership Name: n/a (SEAL) <br />By: n/a <br />(Signature of general partner — attach evidence of authority to sign) <br />Name (typed or printed): n/a <br />Business address: n/a <br />Phone No.: n/a FAX No.: n/a <br />Email: n/a <br />A Corporation <br />Corporation Name: Underwater Engineering Services, Inc. (SEAL) <br />State of Incorporation: Florida <br />Type (General Business, Professional, Service, Limited Liability): General Contractor <br />By: <br />(Signature — <br />c evidence of authority to sign) <br />Name (typed or printed): John T. Glanville <br />Title: Operations <br />Attest <br />(Signature of r . to Secretary) <br />Business address: 3306 Enterprise Road, Fort Pierce, Florida 34982 <br />(CORPORATE SEAL) <br />Phone No.: (772)337-3116 FAX No.: (772)337-0294 <br />Email: aconnelly@uesi.com / tpeterson@uesi.com <br />Date of Qualification to do business is April 1984 <br />00310 -131d Forth REV 04-07 <br />00310-5 <br />F:SPubtic Worla{ENGINEERING DIVISION PROJECTS11712 Wabaeso Fishing Pier•Bddge RemovaM AdrnimBid 000umentstCartrad Oocumentsu3o310 - Bid Form REV 04- <br />07.doc <br />