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tRETUR�i W'ITH BID <br /> DATE September 21 , 2016 <br /> � (If an Individual) (SEAL) <br /> Signature of Bidder <br /> 1 Tax ID#: <br /> ' Business Address & <br /> Email Address <br /> � (If a Co-Partnership) <br /> Firm Name (SEAL) <br /> ' By: <br /> ' Business Address & <br /> Email Address <br /> ' Names of All <br /> Members of Firm <br /> ' <br /> i � (If a Corporation) <br /> Corporate Name Culy Contracting, Inc (SEAL) <br /> By: <br /> I 1 <br /> Vice-Pr dent <br /> ' Business Address & <br /> Email Address <br /> 5 Industrial Park Drive <br /> ' Winchester, IN 47394 <br />� ' Names of Officers Doreen M. Culy <br /> President <br /> Bruce Cul <br /> I ' Y <br /> Secretary <br /> I�i 1 Bruce Culv <br /> Treasurer <br /> ' Attest: � <br /> ' Secret <br />, ' t6 <br />