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SUBMITTED on May 15 , 2019 .. <br />State Contractor License No. CGCo52940 <br />If Bidder is: <br />An Individual <br />Name (typed or printed): <br />By: <br />(SEAL). <br />(Individual's signature) <br />Doing business as <br />Business address: <br />Phone No.:. .. FAX No.: <br />Email: <br />A Partnership (SEAL) <br />Name: ( ) <br />By: <br />(S{gnatUre 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: Timothy Rose Contracting <br />State of Incorporation:. Florida <br />Type (General JSiness, Professional, Service, Limited Liability): Contractor <br />(SEAL) <br />Signature.— attach- evidence of:authority to sign) <br />Name (typed or printed): Timothy Rose <br />Title: President <br />Attest <br />�gnafuof Corporate Secrefaiy) <br />(CORPORATE SEAL) <br />'Business address: 136o SW Old Dixie Hwy Suiteio6 <br />Vero Beach FL 32962 <br />Phone No.: 772.564.7800 FAX No.:. 772.S64.7888 <br />Email TimRose7(Thcomcast.net <br />Date of Qualification to do business is <br />1991 <br />A Joint Venture. <br />Joint Venture Name: (SEAL) <br />00310 - Bid Form REV 04=07 <br />00310-"6 <br />F:1Public Works\ENGINEERING DIVISION PROJECTS\1620-05t11 Slree1_061h Ave to 101st Ave_ Roadway Improvements11-Admin\Rids\BId Ooc.ments\Master.Conliaat <br />pocuments100310 - Bid Form REV 04-07.doc- <br />