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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: _ <br />State of Incorporation <br />Type (Generalsi e <br />By: _ 11—A <br />The Roof Authority, Inc. <br />Florida <br />Professional, Service, Limited Liability): <br />(Signatur-- a`ttach vidence of authority to sign) <br />Name -(type or jnted): Christopher A. Long <br />Title: President <br />(SEAL) <br />(CORPORATE SEAL) <br />Attest <br />(Signature of Corporate ecretary) <br />Business address: 6771 North Old Dixie Hwy <br />Fort Pierce, FI. <br />Phone No.: 772-468-7870 FAX No.: 172-468-4277 <br />Email: <br />- - <br />Email: tral993@gmail.com <br />Date of Qualification to do business is 1993 <br />A Joint Venture <br />Joint Venture Name: (SEAL) <br />By: <br />(Signature of joint venture partner -- attach evidence of authority to sign) <br />00310-5 00310 —Bid Form REV 04-07 <br />FAPublic Works\ENGINEERING DIVISION PROJECTS\1736 IRC Health Department Roof Replacement Project\1-Admin\Bid DocumentsWaster Contract Documents\00310 - Bid <br />Form REV 04-07.doc <br />