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PART H <br />(For projects of $150,000 or more — IC 36-1-12-4) <br />These statements to be submitted under oath by each bidder with and as a part of his bid. (Attach <br />additional pages for each section as needed.) <br />I What public works projects has your organization completed for the period of one (1) <br />year prior to the date of the current bid? <br />Contract Amount <br />Class of Work <br />Completion <br />Date <br />Name and Address of Owner <br />E; -o5- OJ 0, <br />120 <br />J <br />7 9 Z <br />�2', <br />1 A. R <br />1 <br />20 <br />V40rA <br />2. What public works projects are now in process of construction by your organization? <br />Contract Amount <br />Class of Work <br />Completion <br />Date <br />Name and Address of Owner <br />E; -o5- OJ 0, <br />J <br />7 9 Z <br />�2', <br />1 A. R <br />1 <br />2-/J- 2_21 <br />V40rA <br />1) r 1 <br />3. Have you ever failed to complete any work awarded to you?MQ If so, where and <br />why? <br />4. List references from private firms for which you have performed work. <br />ZZ (-IJL C_2141/14 03R r <br />TSC 220060.04 Bid Form Section 00 3100-5 <br />