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A Corporation <br /> Corporation Name ii l 4...c.. e"),_),4--- --,-2-4›, (SEAL) <br /> State of Incorporation' 1)rd► <br /> Type(Gen, ices; Pro ---ionai,Service.Limited Liability): ! - "5•:4^, f .-`>(>_ <br /> By ear... ' <br /> ( na , - -attach evidence of authority to sign) <br /> Name(typed or printed): 7 44k..5. ' <br /> l itis: ? 5 - ' <br /> (CORPORATE SEAL) <br /> Attest: Q`NUO LA <br /> (Signattine(a orpor'ate Secretary) <br /> Date of Qualification to do business in 1,4114r "› 'c34- is 1 /- a i s <br /> (State INtrere Project is Located) <br /> 9.02 Contact Information <br /> Bidder's Business Address: I—1 l 2-5 l...J.-.34.-4a:; 5'7- IA <br /> L ,,,,1e t 1,0 p--) S-5'-'0.--1 <br /> Phone: 11,4"- 'i`D l ci CFacsimile: -7L 'Li Z I - 14'zC E-mail: <br /> Submitted on <br /> u a ,2Q 1l <br /> Slate Contractor License No. -(If applicable) <br /> . <br /> i <br /> Bid Form <br /> ELKMU 134310 00 41 00-5 <br /> 79 <br />