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State board of Accounts <br />Form #102 <br />Approved 12/88 <br />Standard Questionnaires and <br />Financial Statement for Bidders <br />City of Indianapolis <br />Marion County, Indiana <br />Form #102 <br />For use in investigating the qualifications of bidders on public works contracts when the aggregate cost of such contract will be a <br />hundred thousand dollars ($100,000) or more. This form may be used for any other contract when the ordering department requests it. <br />These statements are to be submitted under oath by each bidder with and as a part of the bid. <br />NOTE: THIS FORM BECOMES PART OF THE BID FILE, AND PURSUANT TO INDIANA'S PUBLIC RECORDS LAW (IND. <br />CODE SS5-14-3-1-5-14-3-10), WILL BE AVAILABLE FOR PUBLIC INSPECTION AND COPYING DURING CENTRAL PURCHASING'S <br />REGULAR BUSINESS HOURS WHEN THE TOTAL CONTRACT PRICE EXCEEDS $100,000. <br />Submitted to: City of Indianapolis, Central Purchasing <br />Company Name: Beaty Construction, Inc. <br />Address: 5292 W. 100 N. <br />Boggstown, IN 46110 <br />Representative: Daniel S. Beaty, President <br />Telephone Number: 317-835-2254 <br />Date Submitted: March 26, 2019 <br />TO THE BIDDER: <br />These forms, required by the City of Indianapolis and Marion County, Indiana, have been prescribed by <br />the State Board of Accounts. <br />They properly filled out and attested, must accompany each bid of a hundred thousand dollars ($100,000), <br />or more, If the ordering department requests it, they may be required for bids of lesser amounts as well. <br />The forms are designed to cover all public work Contracts/all other applicable situations and the bidder is <br />required to answer such questions as are pertinent to the work being bid/R.F.Q. The purpose of the questionnaire <br />is to enable the awarding body to determine the qualifications of the bidder to carry out successfully the contract <br />if the same is awarded to the bidder. <br />The bidder will find it to his advantage to answer fully all questions coming within the range of the work <br />being bid. Particular attention should be given to the "Financial Statement" and the details relative to the assets <br />and liabilities set out. This form is made in extensive detail so that the bidder may explain his assets and <br />liabilities in proper sequence and in a uniform manner. NOTE; FAILURE TO FILL OUT THESE FORMS <br />COMPLETELY MAY BE GROUNDS FOR DECLARING THE ENTIRE BID NON -RESPONSIVE. <br />