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(ix) Written statement of any federal, state or local tax liens or tax delinquencies owed <br />to any federal, state or local taxing body in the preceding three years. <br />(i) 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 due. <br />Date: 11� <br />AIX 04 <br />(Sign Here) <br />(Print Name Here) I <br />(Name of Company) <br />(Address of Compa y) <br />(City) <br />\1(State) <br />I'"/ <br />(Telephone Number) <br />Version 7/20/2018 General Conditions - 10 <br />