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SUBMITTED on 04.23 , 20 20. <br />State Contractor License No. CGC 052940 <br />If Bidder is: <br />An Individual <br />Name (typed or printed): <br />Bv: <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 />WIN" <br />I's <br />(SEAL) <br />A Corporation <br />Corporation Name: Timothy Rose Contracting (SEAL) <br />State of Incorporation: Florida <br />Type (Gen Sin ss, Professional, Service, Limited Liability): Construction <br />By: <br />(Signature -- attach evidence of authority to sign) <br />Name (typed or printed): Timothy Rose <br />Title: President <br />(CORPORATE SEAL) <br />Attest G <br />(Signature of Corporate Secretary) <br />Business address: 1360 SW Old Dixie Hwy Suite106 <br />Vero Beach FL 32962 <br />Phone No.: 772.564.7800 FAX No.: 772.564.7888 <br />Email: Ti mRose7(D-comcast.net <br />Date of Qualification to do business is 1991 <br />00310 - Bid Form REV 04-07 <br />00310-11 <br />F:\PublicWorkskENGINEERING DIVISION PROJECTS\1325 58th Avenue (57th St to CR 510) Roadway Inventory\1- <br />Admin\Bids\Bid Documents\00310 - Bid Form REV 04-07.doc <br />