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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: [ l/ <br />(Sign Here) <br />I' A-p K oS <br />(Print Name Here) <br />t kJl? tAAI * C� <br />(Name of Company) <br />1b2 E? l['JLe � <br />(Address of Company) <br />(City) <br />(State) <br />527�k—&;D��g <br />(Telephone Number) <br />