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<br />The Bidder shall furnish the following information. Failure to comply with this requirement may cause <br />its rejection. Additional sheets shall be attached as required. <br /> <br />Contractor's Name/Address: ~~ elJ'T 'J ~ <br /> <br />~~~ ~t 5~jt- <br />()o4.-c;) ~ ,Ii!- L- ~ ~ () Go- c:> <br /> <br />..., <br /> <br />. <br /> <br />.., <br /> <br />. <br /> <br />...., <br /> <br />. <br /> <br />..., <br />. <br /> <br />,.., <br />. <br /> <br />.., <br /> <br />. <br /> <br />..., <br />. <br /> <br />r"1 <br /> <br />4. <br /> <br />. <br /> <br />1"'1 <br />. <br /> <br />1"'1 <br /> <br />. <br /> <br />-, <br /> <br />. <br /> <br />" <br /> <br />. <br /> <br />r"1 <br /> <br />. <br /> <br />.., <br /> <br />- <br /> <br />7. <br />Sll\\~ <br /> <br />,., <br /> <br />. <br /> <br />1"'1 <br /> <br />. <br /> <br />~ <br /> <br />. <br /> <br />,.., <br /> <br />. <br /> <br />..., <br /> <br />09/09 <br /> <br />. <br /> <br />DOCUMENT 00420 <br /> <br />INFORMATION REQUIRED FROM BIDDERS <br /> <br />GENERAL INFORMATION <br /> <br />1. <br /> <br />2. <br /> <br />Contractor's Telephone Number: 9<5" - 771<6 - t lCaO <br /> <br />Contractor's License: (j~L.d" \ "t-~ <br />Primary Classification: 0 c_ \. <br /> <br />3. <br /> <br />Number of years as a Contractor in construction work of the type involved in this Contract: <br />tfJ <br /> <br />5. <br /> <br />List the names and titles of all officers of Contractor's firm: <br /> <br />1/ /rIvt ( 0 ~IJ ut\. 0 :J.. <br /> <br />- rQ~\OC'N' <br /> <br />6. <br /> <br />Name of person who inspected site or proposed work for your firm: <br /> <br />Name: -W frf" 1 0 <br /> <br />8. <br /> <br />TovvfdJ~ <br />oq /u~cr <br />I I <br />What is the last project of this nature you have completed? J <br /> <br />&'II,,,~ t\* '071t8;"7 Sc-Mr; :i-MIV "0"'sY"1 <;. C ~ I D ffO'l-(O-OV <br />C. H-,\ c ~ Sc.; 1\ ",\ ":\ ~t~ (\.-:P(<..- t\ <br />Have you ever failed to complete work awardeato you; if so, where and why? <br /> <br />Date of Inspection: <br /> <br />fio. <br /> <br />00420-1 <br /> <br />03-4122.F <br />