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see attached 96 form <br />PART UU ' <br />(For projects of$1O0.0O0ormore —|O80-1-12-4) <br />These statements to be submitted under oath by each bidder with and as part ofhis/her/its bid. <br />Attach additional pages for each section 8aneeded. <br />SECTION XEXPERIENCE QUESTIONNAIRE <br />1. Attach information regarding projects your organization, has completed for the period of one <br />(1) year prior to the date of the current bid. <br />2. Attach alisting ofpublic works projects oumanUy|nproc8oGofconmtruotionbyyour <br />organization. <br />3. Attach information regarding any failure to complete any work awarded to you and the <br />location thereof. n/a <br />4. Attach references from private firms for which you have performed work. <br />SECTION |lPLAN AND EQUIPMENT QUESTIONNAIRE <br />1. <br />Attach anexplanation ofyour plan, Orlayout for performing proposed work, (Examples could <br />include onarrative ofwhen you could begin work, complete the project, number of vvorkerm, <br />eto and any other information which you believe vv0u|d enable the City ofSouth Bend to <br />consider your bid.) According to specifications <br />2. Attach a listing of the names and addresses of all subcontractors (i.e. persons or firms outside <br />your own firm who have performed part of the work) that you have used on public works <br />projects during the past five (5) years along with a brief description of the work done by each <br />subcontractor. <br />3. If you intend to sublet any portion of the work, attach the name and address of each <br />muboontnaotor, equipment to be used by the subcontractor, and whether you will require a <br />bond. However, if you are unable tocurrently provide mlisting, please understand aUoting <br />must beprovided prior tocontract approval. Until the completion ofthe proposed project, you <br />are under acontinuing obligation toimmediately notify the City cf South Bend |nthe event that <br />you subsequently determine that you will use a subcontractor onthe proposed project. <br />4. Attach olisting ofequipment you have available touse for the proposed project. <br />5. Have you entered into contracts or received offmny for all materials which substantiate the <br />prices used in preparing your proposal? If not, attach an explanation for the rationale used <br />which would corroborate the prices listed. <br />SECTION III CONTRACTOR'S FINANCIAL STATEMENT <br />Attachment of bidder's financial statement is mandatory. Any bid submUfted without said <br />financial mteternerd as required by statute mheU thereby be rendered invalid. The financial <br />statement provided hereunder to the City of South Bend awarding the contract must be specific <br />enough in detail so that said City of South Bend can make a proper determination of the bidder's <br />capability for completing the project if awarded. <br />Version 4/2/2019 Contractor's Bid for Public Works -3 <br />