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PROM <br />PROJECT RIAME: 2017 Brick Column Rqpznr� <br />PROJECT NO. 117-126 <br />QUOTES DUE December 12, 2017 <br />(Must be completed for all quotes. Please type or print) <br />Date: Firm: C v,-A %A-,,, a--J h A- 14 Ti o <br />Address: Z�;- A)l. lva <br />City/State/Zlp: S. N-c-AA , TA) LJ 6Ze, Telephone Number q ) 2 o 8 8L/ <br />Agent of Bidder (if Applicable): A)JA <br />Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the <br />public works project of: <br />the City of South Bend, Indiana, in accordance with plans and specifications prepared by: <br />The City of South Bend. DeDartment of Public Works <br />and dated bec.e�,,,, (3>co- —L4 for the sum of (enter the Total Quote as shown on the Proposal) <br />F'� -r aft'*A'0/ � AtV (s III 493-� <br />(Enter SLIM of Total Quote plus Alternates shown onProposal) (Numerical) <br />If alternative quotes apply, the undersigned submits a proposal for each in accordance with the notice. Any <br />addendums attached will be specifically referenced at the applicable page, <br />if additional units of material included in the contract are needed, the cost of units must be the same as that shown <br />in the original contract if accepted by the City of South Bend, If the quote is to be awarded on a unit basis, the <br />itemization of the units shall be shown on a separate attachment. <br />By <br />ignature) <br />(Printed Name of Person Signing) <br />The above quote is accepted this day of &A-rCC'-�YL-6--)-L., 20 / - I <br />Subject to the following conditions: <br />BOARD OF PUBLIC NOR S <br />nary t ilo Pr si:dent <br />Elizabeth A. Maradik, Member <br />James A. Mueller, Member <br />Suzanna M. Fritzberg, Member <br />A <br />Tlinre J. Dorau, Member <br />---Affest: Linda M. Mart n, Clerk( <br />Version 10118/2016 Page - 1 Public Works Quote <br />