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General Form No. 96-a <br />Prescribed by the State <br />Board of Accounts of Indiana <br />Revised 1949 <br />STANDARD QUESTIONNAIRES AND <br />FINANCIAL STATEMENT FOR BIDDERS <br />Prescribed b <br />THE STATE BOARD OF ACCOUNTS OF INDIANA <br />For use in investigating and determining the qualifications of bidders on public Finance <br />construction when the aggregate cost of any such work or improvement will be <br />Five Thousand Dollars or more. <br />These statements to be submitted under oath by each bidder with and as a part <br />of his bid, as provided by Chapter 306, page 1248, Acts of 1947. <br />OWNER: <br />PROJECT: <br />Submitted by: <br />The City of South Bend, IN <br />227 West Jefferson Blvd <br />South Bend, IN 46601 <br />Fire Station 3 & 6 Renovations <br />Project #118-047 <br />South Bend, IN <br />GIBSON-LEWIS, LLC <br />1001 W. 11th. Street <br />Mishawaka, Ind. 46544 <br />DATE: October 8, 2019 <br />Filed: <br />() A Corporation <br />() A Co -partnership <br />() An Individual <br />(X) A Limited Liability Company <br />