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the progian! and thr. , i Gates Department of Labor Office of Apprenticeship <br />Certificates of Hegi,-,W , ot Apprenticeship Programs for each type of work to be <br />perfommeo on the prcrlt <br />(vi) L - Copy of a written plait ,!nployee drug testing that covers all of my employees <br />who will perform won i _; � they public; work project and meets or exceeds the <br />requirements set forth c 4 13 18-5 or IC 4-13-18-6. <br />(vii) V/ Evidence that I am i;h:iq ;m surety company which is on the Bureau of fiscal <br />Service Department i ;u y :, Listing of Approved Sureties" as required in the <br />bid specifications or r ; wl <br />(viii) V/ Written statement of state or local tax liens or tax delinquencies owed <br />/ to any federal state n ; ii taxing body in the preceding three years. <br />(ix) V List of protects of sinw. e and scope of work performed in all areas, including <br />the State of Indiana vvo rnree (3) years prior to the date on which the bid is due <br />Date. <br />(Sign Here) <br />'.. <br />(Print Name Here) _. <br />wRMA <br />(Name of Company) <br />(Address Company)._._ <br />(City) <br />(State) <br />(Telephone Number) <br />Version 5/20/2024 Gen( : � )I ditions - 15 <br />