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(Must be completed for all quotes. Please type or print) <br />Date; ly/p)h 0 / Firm'. (Os4wefc <br />Address: AR cl q 'F % t I VKIe 12— 0 <br />City/State/Zip.' '). '�lA`A' o tj *610 Telephone Dumber: ( 5,7y ) g 4T CD q & ,4 <br />Agent of Bidder (if Applicable): <br />Pursuant to inotices 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, Department of Public Works <br />and dated for the sum of (enter the Total Quote as shown on the Proposal) <br />(Enter Sum of Total Quote sfiolkni 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 <br />shown in the original contract if accepted by the City of South Bend. If the quote is to be awarded on a unit basis, <br />the itemization of the units shall be shown on a separate attachment. <br />By ;�.Z " / <br />(Signature) <br />-(Printed Name of Person Signing) <br />The above quote is accepted this <br />Subject to the following conditions: <br />Gary A Gilot, Pres <br />Elizabeth A. Maradik, Member <br />,James A. Mueller, Member <br />day of <br />NQ <br />Suzanna M. Fritzber Member <br />Therese J. Dora6,' Member <br />Attest: Linda M. Martin, Clerk <br />Version 10/1812016 Page - 1 Public Works Quote <br />