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TO BE SUBMITTED ON REQUEST <br />The undersigned guarantees the tru b and accuracy .1'.1i statement end answers herein contained. <br />(Pieose um additmard sheers as necessary to fully answer questions) <br />I. How any years has your organ a It el business as a General Cimuamm? <br />1. Whet is the last project ofdiis nature lhm yauhave mleted+ n <br />I Cirr <br />s 3. Have you ever failed m mmpla a nr..,rod awarded to you; if., where and why? <br />I <br />0. Name tIree ilidividual3 or corporations f9cwhich you have performed work and to which you refer: <br />5. Have you LAerPSonally inspected the praposed work and have you a complete plan for its performance? <br />6. Will you mbleo Hiyfpm fthis work? Ifso,givedburls: <br />?. Whet,9gqvipmeptdoyou own that is aveil�blgfor the work? <br />I-II I'i-tY1��F IS JWP RR99.. <br />S. What equiprLcA�mchasc for the proposed work? <br />9. What equipmerdl 11 you rcm for the proposed work? <br />11O Y1E <br />10. The fallowing is given as a summary of the Financial Statement of the undersigned:(List Asset and Liabilities and <br />' wsert sh tifnecess ) <br />n nOn re,-. �oe.a7 %`P ^ WP Id9' 11 n J'rJle, r,/F <br />It. Stale the true, eaacp correct, end complete name of th<partnership, corporation or trade name under which you do <br />business, and the address of the place of business. His corporation, state the name of dm President and Secretary. <br />Ifa partnership, state the names of all partners. If a made name, state the names of die individuals who do business <br />under We made name. It is absolutely necessary that this information be famished.) <br />3)Aal4�iSo, rxI'-GXsP— <br />(Cmrecl Name of Bidder) <br />(a) Thee proprietorship) (Porawrehip) <br />ryoration). <br />Q-1 <br />