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i <br />State Contractor License No. c G C o 3 L, G <br />If Bidder is: <br />A Corp9r9tion --�L � <br />Corporation Name:�-� ��r'`'' L <br />State of Incorporation: t t - <br />Type (General Business, Professional, <br />mited Liabil <br />(Signature — attach evidence of authority to sign) <br />Name (typed or printed): ,tee �G J� • h-� o kss -' <br />Title: V I_POO <br />(SEAL) <br />(CORPORATE SEAL) <br />Attest <br />(Signgturf 'gftorporate Secretary) F� <br />Business address: 739 wcstP''-+ P I <br />I,J- p• B P4 3 3 ti13 <br />Phone No.: ( <6 i J ii 7 i - 4_it a a FAX No.: (5 61) 1171-e348' <br />Date of Qualification to do business is I I / Z ti I V 9 <br />* * END OF SECTION * * <br />00310 - Bid Form REV 04-07 <br />00310-10 <br />F:\Engineering\Capital <br />Projects\0803 17th Lane SW Roadway Improvements from 27th <br />Ave <br />to approx. 900 LF east of 27th Ave\0803 Contract Documents\0031 D - Bid Form <br />REV 04-07.doc <br />