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Attachment C <br />Proposal for Towing Services <br />P!W0--.qa 1r4 <br />I. Business Name: _'�-�4WQ+r�SGQi+�r4� �raL.Email addressneCi1Gile—rnortileS *7 to n -i l toin <br />2. Business Address: 11491 NE IP;Q <br />Phon e �i��" 110 City: W.64h M thm i zip: 3aLb I _ <br />Mailing Address: A4g 1 NE 13o <br />Nar+h M iarn i Zip: ,� <br />State type of business enterprise (e.g. corporation, association, partnership, organization, joint venture, <br />trust, foundation, firm, group, society, individual natural person, etc.): <br />3. NAME ALL OWNERS, OFFICERS, AND PERSONS HAVING AN INTEREST IN THE TOWING AGENCY: <br />(Attach additional sheets if necessary) <br />a. NAME _Kr c ke' I t P. V A I P'0 6 4 SS# : A IL4 OO L4 <br />ADDRESS t231 M Cki h i C `i' re,e)L PHONE q S y' " C� " J5a�(Q �D <br />CITY10 WCQ C_ STATE CL BIRTHDATE :R—,9;3 -1q -7Q <br />b. NAME SS# <br />ADDRESS PHONE <br />CITY STATE BIRTHDATE <br />c. NAME SS# <br />ADDRESS PHONE <br />CITY <br />STATE BIRTHDATE <br />d. NAME SS# <br />ADDRESS <br />CITY <br />PHONE <br />STATE BIRTHDATE <br />e. NAME SS# <br />ADDRESS <br />70r <br />CITY STATE BIRTHDATE <br />4. Has the business enterprise, or any person whose name appears in this application, ever been convicted of any <br />crime? <br />If so, list the name, the arrest and conviction record of each person: <br />(Attach Additional sheets if necessary) <br />5. If a corporation, supply the following: <br />qFf R41-7—ransp&4 <br />t5�t`.01 AT'T'ACHMtaNT" "'-'res oo- �-tiwina-a- mravevu Zn4 . <br />