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2. Company Name*
4. Address*
6. City*
7. State*
8. Zip Code*
10. Phone Number*
11. Fax Number
13. Email Address*
15. Instructions
    Once the electronic bid packet is obtained it must be saved or printed before closing. Bidders shall submit their sealed bids to the City Engineer at 3635 – 4th Avenue, Moline, IL before 11:00 a.m. on November 11, 2018 at which time they will be opened and publicly read.
17. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
19. Electronic Signature*
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21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field