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F-1W61:1 2 r-11 11101 <br />The above bid is accepted this q day of <br />Subject to the following conditions: <br />BQARD OF PUBLIC W10 <br />4 7n,- <br />Gary Gilot, Presi ent <br />Clkza6elh A. Maia-dik, Member <br />James A. Mueller, Member <br />V <br />Suzanna M. Fritzberg:, Member <br />T h 'ese J. Dor d,-MeM'b'6r <br />"-A$est: Linda M. Miahin, CWk <br />PART 11 <br />(For projects of $100,000 or more - IC 36-1-12-4) <br />These statements to be submitted under oath by each bidder with and as part of his bid. <br />Attach additional pages for each section as needed. <br />SECTION I EXPERIENCE QUESTIONNAIRE <br />1. Attach information regarding projects your organization has completed for the period of one <br />(1) year prior to the date of the current bid. <br />2. Attach a listing of public works projects currently in process of construction by your <br />organization. <br />3. Attach information regarding any failure to complete any work awarded to you and the <br />location thereof. <br />4. Attach references from private firms for which you have performed work. <br />611=1011163011 1 11111;JW-110E-11,4111*111 I;1TJ40kd[#1111=6t 11ININLIFT-110 <br />1. Attach an explanation of your plan or layout for performing proposed work. (Examples could <br />include a narrative of when you could begin work, complete the project, number of workers, <br />etc. and' any other information which you believe would enable the City of South Bend to <br />consider your bid.) <br />2. Attach a listing of the names and addresses of all subcontractors (i.e.. persons or firms outside <br />your own firm who have performed part of the work) that you have used on public works <br />projects during the past five (5) years along with a brief description of the work done by each <br />subcontractor. <br />3. If you intend to sublet any portion of the work, attach the name andl address of each <br />subcontractor, equipment to be used by the subcontractor, and whether you will require a <br />bond. However, if you are unable to currently provide a listing, please understand a listing <br />must be provided prior to contract approval. 'Until the completion of the proposed project, you <br />are under a continuing obligation to immediately notify the City of South Bend in the event that <br />you subsequently determine that you will use a subcontractor on the proposed project. <br />4. Attach a listing of equipment you have available to use for the proposed project. <br />Version 10/17/2017 Contractor's Bid for Public Works - 9 <br />