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See Attached 96 Form <br />PART II <br />(For projects of $100,000 or more — IC 36-1-12-4) <br />These statements to be submitted under oath by each bidder with and as part of his/her/its bid. <br />Attach additional pages for each section as needed. <br />SECTION I EXPERIENCE 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 a listing of public works projects currently in process of construction by your <br />organization. <br />3. Attach information regarding any failure to complete any work awarded to you and the <br />location thereof. <br />4. Attach references from private firms for which you have performed work. <br />SECTION II PLAN AND EQUIPMENT QUESTIONNAIRE <br />1. Attach an explanation of your plan or layout for performing proposed work. (Examples could <br />include a narrative of when you could begin work, 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 bid.) <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 />subcontractor, equipment to be used by the subcontractor, and whether you will require a <br />bond. However, if you are unable to currently provide a listing, please understand a listing <br />must be provided prior to contract approval. Until the completion of the proposed project, you <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 a subcontractor on the proposed project. <br />4. Attach a listing of equipment you have available to use for the proposed project. <br />5. Have you entered into contracts or received offers 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 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 01/13/2021 Contractor's Bid for Public Works - 3 <br />