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/iddeii:d rri 2, <br />NAME OF BIDDER: <br />Licensed in accordance with an act for the registration of Contractors, and with license <br />number: 6 7 936 -'; Expiration: 0)-30-2-7 <br />_ �] r �= <br />� <r t : Lk �c1V��t_ _!c . t / i rt r e315 - <br />(Place of Incorporation, if Applicable) (Principal) <br />,M scl.te ll __ W rl �'r ✓' <br />(Principal) <br />a/yt �- ,y i,,, ivv - S 2 -v � "r"«.,,- <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 />By: A4A e vy k -t , <br />(Signat e) <br />Its. <br />Title (If Corporation: Chairman, President <br />or Vice President) <br />(Signature) <br />Its: rQ 5+J-v�— <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 />L_, v t- ; -Nn t) r CA � 55 <br />Contractor's Representative(s): <br />-5a ' /hV l i�((ce-/ <br />- t V E, 1 V C <br />VERA AVENUE BIKE BOULEVARD PROJECT 004113-6 <br />