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shown in the original contract if accepted by the City of South Bend. If the bid is to be awarded on a unit <br />basis, the itemization of the units shall be sho n on a separate attachment. <br />B <br />�nin <br />�.(signature) �.1 I.. —.. .. a <br />(PruntCd Horne of Person ,ic <br />ACCEPTANCE <br />The above bid is accepted this day of <br />Subject to the following conditions: <br />BOARD OF PUBLIC WORKS <br />Gary A. Gilot, President <br />Elizabeth A. Maradik, Member <br />James A. Mueller, Member <br />Suzanna M. Fritzberg, Member <br />Therese J. Dorau, Member <br />Attest: Linda M. Martin, Clerk <br />PART II <br />(For projects of $100,000 or more — IC 36-1-12-4) <br />20 <br />These statements to be submitted under oath by each bidder with and as part of his/her/its bid. <br />Attach additional pages for each section as needed. <br />SECTION I EXPERIENCE QUESTIONNAIRE <br />1. Attach information regarding projects your organization has completed for the period of one <br />(1) year prior to the date of the current bid. <br />2. Attach a listing of public works projects currently in process of construction by your <br />organization. <br />3. Attach information regarding any failure to complete any work awarded to you and the <br />location thereof. <br />4. Attach references from private firms for which you have performed work. <br />SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE <br />1. Attach an explanation of your plan or layout for performing proposed work. (Examples could <br />include a narrative of when you could begin work, complete the project, number of workers, <br />etc. and any other information which you believe would enable the Pity of South Bend to <br />consider your bid„) <br />2, Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside <br />your own firm who have performedpart of the work) that you have used on public works <br />projects during the past five () years along with a brief description of the work done by each <br />subcontractor, <br />If you intend to sublet any portion of the work, attach the name and address of each <br />subcontractor, equipment to be used by the subcontractor, and whether you will require a <br />Version 7/20/2018 Contractor's Bid for Public Works - 3 <br />