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<br />SUBMITTED THIS <br /> <br />DAY OF <br /> <br />,20 <br /> <br />If BroDER is: AN INDMDUAL <br /> <br />By (SEAL) <br /> <br />(Individual's Name) <br /> <br />Doing business as : <br />Business address <br /> <br />Phone No <br />Facsimile No <br /> <br />If BIDDER is: A PARTNERSHIP <br /> <br />By (SEAL) <br /> <br />(Firm's Name) <br /> <br />General Partner <br />Business address <br /> <br />Phone No <br />Facsimile No <br /> <br />If BIDDER is: A CORPORATION <br /> <br />By <br /> <br />CHI-ADA CORPORATION <br /> <br />(Corporation's Name) <br />~~ n~ Florida <br />Bart Okoro. <br />(Name of Person Authorized to Sign) <br />President <br />Ij) NW 163rd Street Miami Fl 33169 <br /> <br />State of Incorporation: <br />Representative <br /> <br />Title <br />Busim.'Ss address <br /> <br />Phone NQ <br />- ~acsimile No <br /> <br />p05 ~ 948-5651 <br />305 948-9558 <br /> <br />~~ <br /> <br />Attest: <br /> <br />(President) <br /> <br />(Corporate Seal) <br /> <br />If BIDDER is: A JOINT VENTURE <br /> <br />(Name) (Address) <br /> <br />(Name) (Address) <br /> <br />PAGE 45 OF 78 <br />