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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: �/S /a � _,_ <br />(Sign Here) <br />MAX ���-K%Y <br />(Print Name Here) <br />PR��yu.n Cd NOTE 5�"R ��c.E 5 <br />(Name of Company) <br />7/,,Z f(y�r�onlb ST <br />(Address of Company) <br />,E � K N��T -��, y�s� � <br />(city) <br />r� <br />(State) <br />S7y� �t�y-or i� <br />(Telephone Number) <br />Version 02/23/2022 General Conditions - 14 <br />