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/`ai1defiCi.wn <br />NAME OF BIDDER: <br />Licensed in accordance with an act for the registration of Contractors, and with license <br />number: � 7- 9:1&S __ _ Expiration: 1�- 30 -2�7 <br />(Place of Incorporation, if Applicable) (Principal) <br />C-kQ_Nle- W r�g �-+ -y-P <br />(Principal) <br />(Principal) <br />I certify (or declare) under penalty of perjury under the laws of the State of California that <br />the foregoing is true and correct. <br />(Signat e) <br />Its: 4 - <br />Title (If Corporation: Chairman, President <br />or Vice President) <br />By: 3 - - " _ s-,% ?_; v <br />(Signature) <br />Its: L8 ssde�•�� <br />Title (If Corporation: Secretary, Assistant <br />Secretary, Chief Financial Officer or <br />Assistant Treasurer) <br />NOTE: If Bidder is a corporation, set forth the legal name of the corporation together with the <br />signature of the officer or officers authorized to sign contracts on behalf of the corporation. <br />If Bidder is a partnership, set forth the name of the firm together with the signature of the <br />partner or partners authorized to sign contracts on behalf of the partnership. <br />Business Address: <br />V`J - LT`"C-k _ L-0 ^ 0te I i�; y <br />L.ytrr_-�F)re GA 9YSSI _ <br />Contractor's rRepresentative(s): <br />� <br />,50- A/' �3,/ ; n o V$ <br />VERA AVENUE BIKE BOULEVARD PROJECT 004113-6 <br />rvW <br />