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(ix) _ Written statement of any federal, state or local tax liens or tax delinquencies <br />owed to any federal, state or local taxing body in the preceding three years. <br />W / List of projects of similar size and scope of work performed in all areas, including <br />the State of Indiana, within three (3) years prior to the date on which the bid is <br />due. <br />Date: M OW � O <br />(Sign Here) <br />%_; A ! <br />(Print Name Here) <br />c s <br />Name f Company) <br />(Address of Company) <br />(City) <br />(State) <br />5 �1 k 28 <br />�— <br />(Telephone Number) <br />