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ITEMIZED BID SCHEDULE <br />,w Project Name : #0209 4L' Street/Cooch Ditch Bridge Replacement #9321 11th Street SW <br /> Paving an-d—Drraii �nagel , <br /> Bidder Name: I t �D�V1u �f�'jQ� ac- . <br /> w. <br /> SUBMITTED on , 20 cap r f <br /> i State Contractor License No . C G C 05 Q(;—I `-I u <br />• If Bidder is : <br /> An Individual <br />'w Name (typed or printed) : <br /> By: (SEAL) <br /> r (Individual's signature) <br /> Doing business as: <br /> Business address: <br /> Phone No . : FAX No. : <br /> A Partnership <br /> Partnership Name: (SEAL) <br /> r 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 /> r A CCorporttio 7 Lt l / t 1 <br /> Corporation Name: OSL L OY1IM L) <br /> State of Incorporation: I(Q 0 \ � <br /> Type (General r ssional , Service, Limited Liability) : <br /> B ' <br /> w ure — attach evidenc <br /> e <br /> -�off authority <br /> ' to .sig1n') ' <br /> Name (typed or printed) : ! 111'1fl 'C7� 1 W • `D <br /> Title: <br /> (CORPORATE SEAL) <br /> Atte <br /> w lgnature o Corporate Secretary) a f <br /> B sin ss ddress: 13Lo W W b � <br /> w a � <br /> Phone o. : Sfolf - 7 $Do FAX <br /> w <br /> 0209-00310 - Bid Form Alt..doc <br /> 00310 - 7 <br /> w F:1Engineeting\Capital ProjectsW20941h Sheet Bridge Over Coodt ORCOD209<th Street Bridge Over Co 07-20-06102094)0310 - Bid Form Alt.Ow Rev. 05701 <br />