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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOW-S QWQTE FOR PUBLIC WORK <br />1865 <br />PROJECT NAME: 2017 Crack Sealing <br />PROJECT NO. .1117-102 <br />QUOTES DUE, December 19, 2017 at 9:00 am EST <br />(Must be completed for all quotes. Please type or print) <br />Date: <br />Address: <br />City/State/Zip: <br />Agent of Bidder (if Appfichble): _ <br />Pursuant to notices given, the u <br />public works project of: <br />Firrw <br />I <br />Telephone Number: 6f-7—q ) ALI r 7 — () K M <br />offers to furnish labor and/or material! necessary to complete the <br />— pf,K+ . I !i � - <br />the City of South, Bend', Indiana, in acc6rdance with plans and specifications prepared by: <br />The City of South Bend, Department of Public Works <br />and dated for the sure of (enter the Total Quote as shown on the Proposal) <br />4�i, Ai (s 95 1 coo -A�:--J- <br />nter Sum of Totai Quote shown on Proposal) (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 />(&nature) <br />(Printed Name 'of Person Signing) <br />FA001142fillil'[011 ill <br />The above quote is accepted this day of 20 <br />Subject to the following conditions: <br />BWRD OF PUB17R <br />X4, w K <br />/Wry A. Gil President <br />Elizabeth A. Maradik, Member <br />James Mueller, Member <br />Suzanna M. Fritzberg, Member <br />11-T e . se J. Dora6 Wern r <br />est: Linda M. Martin�Clerk <br />Version 10131/2017 Page - 7 Public Works Quote <br />