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<br />c <br /> <br />SUBMITTED THIS <br /> <br />DAY OF <br /> <br />,20 <br /> <br />If PROPOSER is: AN INDIVIDUAL <br /> <br />By: <br /> <br />(SEAL) <br /> <br />(Individual's Name) <br /> <br />Doing business as: <br />Business address: <br />Phone No: <br />Facsimile No: <br /> <br />If PROPOSER is: A PARTNERSHIP <br /> <br />By: <br /> <br />(SEAL) <br /> <br />(Firm's Name) <br /> <br />General Partner: <br />Business address: <br />Phone No: <br />Facsimile No: <br /> <br />. <br /> <br />If PROPOSER is: A CORPORATION <br />By:1A (;r (ffl no (I~ SifV I U., , I t10 " <br />I:"'-Pr\J~co~grationls Na ) <br />State of Incorporation: U L-V' v- <br />Representative: ~tvv lrv . ~rDO k5 <br />CPo ( "ame of Person Authorized to Sign) <br />Title: <br />Business address: I O)C t.--5 tj <br />Phone No: ,- .?Y1 - 2- <br />Facsimile No: 2J..I <br /> <br />(Corporate Seal) <br /> <br /> <br />LJ '2J5 /tJ <br /> <br />~ <br /> <br />If PROPOSER is: A JOINT VENTURE <br /> <br />(Name) <br /> <br />(Address) <br /> <br />(Name) <br /> <br />(Address) <br /> <br />(Each joint venture must sign. The manner of signing for each individual, partnership, and corporation that is a party <br />to the joint venture should be in the manner indicated above.) <br /> <br />DOCUMENT CONTINUES ON NEXT PAGE <br /> <br />o <br /> <br />46 <br />