THIS FORM MUST BE SUBMITTED WITH ALL RESPONSES TO /FB
7. The following documents are attached to and made a condition of this BID:
A. Bid Form — which includes a tabulation of Subcontractors, Suppliers and other individuals and entities
required to be identified in this proposal;
B. Schedule of Values:
C. Bid Bond;
D. Construction Contractor’s Qualification Statement; and
E. Any and ail addendums issued after the release of this BID. Upon issuance, addendums can be found
on the City website or on Bid Express with the original BID documents
8. Communications concerning this BID shall be addressed to:
Kelly Parkinson, Purchasing Manager
Email: purchasing@nashuanh.gov
. CA
SUBMITTED on Februcvy 1 0 22.
Business Name (typed or printed): Suan Shine aA mare) Covpeva tr LY?
(J individual [_] Partnership [og Corporation [J Joint Venture
Type:
CO General C] General
C] Publicty Traded (3 Professional
C1 Limited [Wservices
My (1 other CJ umited Liability
Robe EBs Ane ll Pes don t (SEAL)
(individuat’ 's Sgnature, General Partner, Lf with authority to sign)
Doing Business as): Su Shi awe] \ ON i Vater Coe pora AW
Business Address: Oy Cin s
aad Scr . NS A OxOSy
Phone: (oC) x ais -SWOO emai: bebe Sunsnmre pavivy; tery]
Date and State of Organization: \\ We
Date and State of Incorporation: 2\ Als WriaSSacnu pods
Date of Qualification to do business is >\ Ale
Names of Current General Partners/Executive Officers/Joint Partners
Name: Title
PO cese - VWoushno\\ Presitent
Manico ~BuShre \W\ WeeaSurer-
(Indicate managing partner by an asterisk *)
IFBO660-020922 2022 PAVING PROGRAM Page l3of5
