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General Form No. 96-a <br />Prescribed by the State Board of <br />Accounts of Indiana. Revised 1949. <br />Standard "uestionnaires and <br />Y a Statement Bidders <br />Prescribed by <br />THE STATE BOARD OF ACCOUNTS OF INDIANA <br />For use in investigating and determining the qualifications of bidders on public <br />construction when the aggregate cost of any such work or improvement will be Five Thousand <br />Dollars or more. <br />These statements to be submitted under oath by each bidder with and as a part of his bid, as provided <br />by Chapter 306, page 1248, Acts of 1947 <br />Submitted to City of South Bend .Indiana <br />By,__.... Walsh & Kell.,_Inc....................m.................................................... �. <br />Address 24358 SR 23 South Bend IN 46614 <br />Date submitted November 26, 2019 <br />Filed <br />A.F.. AC7YCF. CO., MttIVCPE, [PdPJ, <br />tA Corporation <br />1 <br />