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shown in the original contract if accepted by the City of South Bend. If the bid is to be awa ed on a unit <br />basis, the itemization of the units shall be s n on a eparate, tta fi`(nent <br />y � <br />�Cai ea d d t c �# <br />Prinfod Name of Person Signing) <br />ACCEPTANCE <br />The above bid is accepted this _ % c� day of 20 <br />Subject to the following conditions: <br />)A I <br />SuzannM. <br />ergse Dor ,Member <br />ll <br />to Linda M. Man, C erk <br />PART II <br />(For projects of $100,000 or more — IC 36-1-12-4) <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 11 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 City 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 performed part of the work) that you have used on public works <br />projects during the past five (5) years along with a brief description of the work done by each <br />subcontractor. <br />3. 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 />