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ACCEPTANCE <br />The above bid is accepted this day of <br />following conditions: <br />Contracting Authority Members: <br />PART II <br />(For projects of $150,000 or more — /C 36-1-12-4) <br />Governmental Unit: CITY OF SOUTH BEND BOARD OF PUBLIC WORKS <br />Bidder (Firm) <br />PREMIUM CONCRETE SERVICES, INC <br />Date (month, day, year): 3/7/2022 <br />subject to the <br />These statements to be submitted under oath by each bidder with and as a part of his bid. <br />Attach additional pages for each section as needed. <br />SECTION I EXPERIENCE QUESTIONNAIRE <br />What public works projects has your organization completed for the period of one (1) year prior to the <br />date of the current bid? <br />Contract Amount <br />Class of Work <br />Completion <br />Date <br />Name and Address of Owner <br />657,021.80 <br />CONCRETE CONSTRUCTION <br />10/18/21 <br />City of Goshen <br />250,000.00 <br />CONCRETE CONSTRUCTION <br />12/31/21 <br />City of Mishawaka <br />163,377.40 <br />CONCRETE CONSTRUCTION <br />12/31/21 <br />City of Elkhart <br />What public works projects are now in process of construction by your organization? <br />Contract Amount <br />Class of Work <br />Expected <br />Completion <br />Date <br />Name and Address of Owner <br />536,800.00 <br />CONCRETE CONSTRUCTION <br />7/30/22 <br />FAIRFIELD JR/SR HIGH SCHOOL <br />