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1.4.12 Affidavit: <br />Thee` undersigned states that this is a genuine proposal and neither <br />collusive <br />nor made in the interest of any other person and has not <br />induced anyone to submit a sham bid <br />or to comply with all applicable <br />statutory requirements as stipulated in the Notice to Contractors. <br />NAMEOF BIDDEIVr L.I. N L <br />BY <br />TITLE FftS <br />_ <br />ADDRESS <br />PHONE NO. J f D'.'r.3 4 0 <br />CONTRACTOR'S LICENSE <br />IDENTIFICATION NO.�"8f 9si3 <br />DATE_b►�"' . <br />R <br />Incorporated Under Laws of the State of 1 tTL <br />President. 1ZAb <br />Secretary__ <br />Treasure&k=L r , <br />State License Number ,3 0.2-% <br />"(Corporate Seal) <br />(Note; If bidder is a corporation, p n, proposal must be signed by an <br />authorized officer the <br />of corporation and corporate seal affixed. <br />Proposal must be accompanied by a document evidencing uch officer is <br />authorized to sign.) <br />Check one; ( ) Owner <br />Y <br />( ) Partnership <br />( ) Company <br />Corporation <br />( ) Other <br />Joint Ventura <br />1 <br />1.4-12 <br />f <br />