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I <br /> PROPOSAL SIGNATURE SHEET I <br /> The undersigned bidder understands that the quantities mentioned herein are approximate only and are <br /> subject to increase or decrease, and hereby proposes to perform all quantities of work as either increased or <br /> decreased in accordance with the provisions of the Drawings and Specifications and at the unit prices bid in , <br /> the Bid Schedule, unless such schedule designates lump sum bids, or force account items. <br /> The full names and residences of all persons and parties interested in the foregoing bid as principals are as , <br /> follows: <br /> Name Title Address <br /> /t'lecime,I Lee Pres►'dcml' P.R 130T 1016 Issg oh, tom} ca0a? <br /> 7611'rne Lee Kc_e Pres(Ali P.O. 130- 7016 Ts'sa/uwh, L'* ft'°d'7 I <br /> Nor IwooI5 h C Pp P.Q. 13ox 706 T�'°'Z"•hi 9bP0a7 <br /> 1 <br /> I <br /> I <br /> The name and mailingaddress of the SuretyCompany which will furnish the required Performance Bond is: I <br /> P Y q <br /> Pqr ker. Sm,fh Fee k of aa33 I I a 1'1' A,,e iv e &eflev+e, w� mot/ I <br /> Surety Company Representative: <br /> S cfs yn t 5Qn LOS - 7©ct - 3 G aS <br /> Bidder acknowledges receipt of Addenda 1 through 3 <br /> Bidder has reviewed the third party liability insurance provisions of the Contract and hereby certifies that 1 <br /> coverage will be provided as required. X. Yes No <br /> Name of Bidder: Lakeside I ndos fries, Xsi c. <br /> Bidder Mailing Address: P.O. 80 a 417 /Monroe , w'A 9?a 7; <br /> I <br /> Phone: Lfas- 743- 1n9 Email: Cooper <br /> I <br /> License of Washington Contractor's No. LA KCSZ4t 179TD <br /> Signature of Bidder's Authorized Agent: , 1. I <br /> Dated at: /119brot) t+/4 Date: y'13-a'0/ <br /> I <br /> 2021 PAVEMENT MAINTENANCE OVERLAY PAGE 28 OF 35 DIVISION P <br /> WORK ORDER 3751 MARCH 29,2021 I <br />