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General Form No. 96-a <br />l'lmscHhed by the Siate l'ytpard of <br />Accounts of Indiana, Revised 1949. <br />II I °� � #u I • �I it • <br />Prescribed by <br />THE STATE BOARD OF ACCOUNTS OF INDIANA <br />For use in investigating and determining the qualifications of bidders on public <br />construction when the aggregate cost of any such work or improvement will be Five Thousand <br />Dollars or more. <br />These statements to be submitted under oath by each bidder with and as a part of his bid, as provided <br />by Chapter 306, page 1248, Acts of 1947 <br />Submitted to City of South Bend Indiana <br />By _ Walsh & KellL lnc, <br />Address 24358 SR 23 South BendIN 46614 <br />Date submitted Auggst 13 2019 <br />Filed <br />A,E. BOYCE CO., MUNCIE, IIND. <br />IA Corporation <br />1 <br />