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(ix) 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 />(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 due. <br />Date: August 13.2,019 <br />�CO <br />(Sign Here) <br />µa, Gj <br />ww••,w,. <br />w wwww <br />� <br />�G w <br />Bill Favors Presidents <br />(Print Name Here) <br />w ,.� C) <br />Ziolkowski Construction, Inc. <br />s �A <br />(Name of Company) <br />'��«w...w•` <br />4050 Ralph Jones Drive <br />(Address of Company) <br />(City) <br />(State) <br />South Bend <br />Indiana 46628 <br />574-287-1811 <br />(Telephone Number) <br />Preparer: Shannon Reidenbach, sreidenbach@zbuild.com <br />574-287-1811 ext 271 <br />Version 3/19/2019 General Conditions - 10 <br />