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s <br /> SUBMITTED on 20_ <br /> rr <br /> State Contractor License No . <br /> If Bidder is: <br /> An Individual <br /> Name (typed or printed): <br /> r <br /> By: (SEAL) <br /> (individual's signature) <br /> .+ Doing business as: <br /> Business address: <br /> Phone No . : FAX No. : <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 /> 1. <br /> Business address: <br /> • Phone No. : FAX No . : <br /> A Corporation <br /> Corporation Name: (SEAL) <br /> State of Incorporation : <br /> r Type (General Business, Professional , Service, Limited Liability): <br /> By: <br /> (Signature — attach evidence of authority to sign) <br /> it <br /> Name (typed or printed): <br /> i^ Title: <br /> (CORPORATE SEAL) <br /> Attest <br /> r (Signature of Corporate Secretary) <br /> Business address: <br /> s Phone No. : FAX No . : <br /> r Date of Qualification to do business is <br /> 00310 - Bid Form REV 04-07.doc <br /> r 00310 - 2 <br /> F'\Ergineedng\Capital Projeota\9611-CR 512 Widening19611 CR 512 PHASE MCaMd DommeM V)0310 - Bid Form REV 0 -07.dm <br />