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(ix) Written statement of any federal, state or local tax liens or tax delinquencies <br />owed 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 <br />due. <br />Date: S 1,2 R IZ4 <br />(Sign Here) <br />(Print Name ere) <br />C�y Ckaml 4 Liun-- cc rS -inG <br />(Name of Company) <br />(Address of Com-panW <br />Lo'� �C_ <br />(City) <br />(State) <br />r.21q) 3-1- ea" k i <br />( elephone Number) <br />Version 07/19/2023 General Conditions -15 <br />