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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: 1 —1 Z — Zo <br />(Sign Here) <br />ci 0. <br />(Print Name Here) <br />PO 1 0, f C, CeLk A <br />(Name of Company) <br />I Z_3 � Pcai r o0 <br />(Address of Company) <br />S©Vt-h <br />(City) <br />Z <br />(State) <br />9 55 - 5 37- 5423 <br />(Telephone Number) <br />Version 3/19/2019 General Conditions -10 <br />