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see attached S0form <br />PART 11 <br />(For projects of$10O.000ormore —}C86-1-12~4) <br />These statements tobesubmitted under oath bveach bidder with and oapart ofh|o/her/itabid. <br />Attach additional pages for each section meneeded. <br />SECTION I EXPERIENCE QUESTIONNAIRE <br />1. Attach information regarding projects your organization has completed for the period of one <br />(1)year prior tothe date ofthe current bid. <br />2. Attach m listing ofpublic works projects currently in process of construction by your <br />organization. <br />3. /\ftonh information regarding any failure to complete any work awarded to you and the <br />location thereof. <br />4. Aftech references from private firms for which you have perf6rrned work. <br />SECTION 11PLAN AND EQUIPMENT QUESTIONNAIRE <br />1.Attach an explanationof your plan orlayout for performing proposed work. (Examples could <br />include e narrative of when you could begin vvork, complete the project, number of workers, <br />etc. and any other information which you believe would enable the City of South Bend to <br />consider your b\d.) <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 />3. If you intend to sublet any portion of the work, odooh the name and address of each <br />mubcontractor, equipment to be used by the mubcontnaotor, and whether you will require a <br />bond. However, if you are unable tncurrently provide a Uoting, please understand a listing <br />must be provided prior to contract approval, Until the completion of the proposed project,yuu <br />are under a continuing obligation to immediately notify the City of South Bend in the event that <br />you subsequently determine that you will use asubcontractor onthe proposed project. <br />4.Attach olisting of equipment you have available to use for the proposed project. <br />5. Have you entered into contracts or received offers for all rnotoda|o which substantiate the <br />prices used in preparing your proposal? If not, oftoch 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 -submitted without said <br />financial statement as required by statute shall 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 01M3X2o21 Contractor's Bid for Public Works -3 <br />