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<br />Version 07/19/2023 General Conditions - 15 <br />the program, and the United States Department of Labor Office of Apprenticeship <br />Certificates of Registration of Apprenticeship Programs for each type of work to be <br />performed on the project. <br />(vi) ___ Copy of a written plan for employee drug testing that covers all of my employees <br />who will perform work on the public work project and meets or exceeds the <br />requirements set forth in IC 4-13-18-5 or IC 4-13-18-6. <br />(vii) ___ Evidence that I am utilizing a surety company which is on the Bureau of Fiscal <br />Service “Department of Treasury’s Listing of Approved Sureties” as required in the <br />bid specifications or contract. <br />(viii) ___ 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 />(ix) ___ 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 /> <br /> <br /> <br />Date: ___________________________________________ <br /> <br /> <br />________________________________________________ <br />(Sign Here) <br /> <br />________________________________________________ <br />(Print Name Here) <br /> <br />________________________________________________ <br />(Name of Company) <br /> <br />________________________________________________ <br />(Address of Company) <br /> <br />________________________________________________ <br />(City) <br /> <br />________________________________________________ <br />(State) <br /> <br /> <br />________________________________________________ <br />(Telephone Number) <br /> <br />X <br />X <br />X <br />X <br />6/11/24 <br />X <br />Brian T. Larson, President <br />Larson-Danielson Construction Company, Inc. <br />302 Tyler Street <br />LaPorte <br />IN <br />219-362-2127 <br />LARSON-DANIELSON <br />CONSTRUCTION CO., INC. <br />S T A TE OF <br />INDIA AN <br />SEAL <br />C orporate