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<br /> Information for Bids <br /> Page 12 of 16 <br /> ADDITIONAL INFORMATION <br /> 1. Company Name /'lee ON/Pll/) >()(...tJ7/0,J.J, (AlC, <br /> 2. Address from which product will be shipped: C/)(;c S'YfTëM f /)If,1<18t1r)f),J F,ýutlry <br /> 3. Number of Years Providing the Specified Product ¡ Y£nl/-s <br /> 4. Business Organization (Check One): <br /> 0 Individual Proprietorship <br /> ~ Partnership <br /> Corporation <br /> 0 Other <br /> If incorporated, provide the following information: <br /> Date of incorporation / !ZJ' /24() Ý State of incorporation AloFt/A/)4 <br /> Names and Titles of All Officers and Directors rø II? ßv126E"'( / I'lfF>11J t~r Ie Ii' IJ <br /> 6L~¡VNIYJ~A/tIJ', fVI'/CPP &ê~"UJ ¡(e/t/;VEf/. (;b~I'P,I(I1Tê .5"êClf'ë T/I;!f,/ <br /> , <br /> . <br /> If an individual or partnership, provide the following information: <br /> Formation date of Company <br /> Name and address of all partners, indicating whether they are general or limited partners: <br /> 5. Tax ID Number ;¡,-tJl"tÇ337 <br /> 6. Indicate whether bidder has ever failed to complete any contract awarded to it. If so, note when, where and why. <br /> Attach additional sheets, if necessary. <br /> 7. Indicate whether bidder has been or is the subject of a bankruptcy or insolvency proceeding or subject to <br /> assignment for the benefit of creditors. <br /> . <br /> @ <br /> -, -"" <br />