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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: (", 2 — a <br />(Sig(i Here) <br />r `C 0,3 !tet D <br />(Print Name Here) <br />(Name of Company) <br />/0 ,3 �- 3 <br />(Address of Company) <br />O's <br />(City) <br />L .✓ <br />(State) <br />(Telephone Number) <br />Version 01/13/2021 General Conditions - 10 <br />