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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S U TE FOR PUBLIC WORK <br />PROJECT NAME: <br />PROJECT NO, <br />QUOTES DUE <br />2022 Microsurfacin <br />122-011 <br />July 12th, 2022 at 9:00am Local Time. Quotes are to be submitted <br />electronically to bawbids(a.southbend in;gov <br />(Must be completed for all quotes. Please type or print) <br />Date: ,q Q `� off- Firm: _14 <br />Address: P.0 .d L <br />City/State/Zip: 301 A,T-AJ 14(a�,rOTelephone Number: {5�) <br />Agent of Bidder (if Applicable): Ai 1A <br />Pursuant to notices given, the undersig ed offers to furnish labor and/or material necessary to complete the <br />public works project of: <br />2022 Microsurfacin <br />the City of South Bend, Indiana, in accordance with plans and specifications prepared by: <br />The City of South Bend, Department of Public Works <br />and dated 7l �� Q �' for the sum of (enter the Total Quote as shown on the Proposal) <br />Gw h ung Lfhogwd . Plyc hurdleekset) +y *0 s <br />(Enter Sum Total Quote shown on Proposal) -v- wY+q Ckk& (Numerical) <br />If alternative quotes apply, the undersigned submits a proposal for each in accordance with the notice. Any <br />addendums attached will be specifically referenced at the applicable page. <br />If additional units of material included in the contract are needed, the cost of units must be the same as that shown <br />in the original contract if accepted by the City of South Bend. If the quote is to be awarded on a unit basis, the <br />itemization of the units shall be shown on a separate attachment. <br />By <br />(Signature) <br />(Printed Name of Person Signing) <br />ACCEPTANCE <br />The above quote is accepted this day of <br />Subject to the following conditions: <br />BOARD OF PUBLIC WORKS <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />Murray Miller, Member <br />Version 2/14/2022 <br />20 <br />Joseph R. Molnar, Vice President <br />Jordan V. Gathers, Member <br />Attest: Theresa Heffner, Clerk <br />Page - 7 Public Works Quote <br />