HomeMy WebLinkAbout09) Questionnaires & Financial Statement for Bidders(Dan Cristiani)
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Gen.ro Fonn No. 96-.
Prescribed by the State
Board of Accounts of
Indiana. Revised 1949
STANDARD QUESTIONNAIRES AND
FINANCIAL STATEMENT FOR BIDDERS
Prescribed by
THE STATE BOARD OF ACCOUNTS OF INDIANA
For use in investigating and determining the qualifications of bidders on public
construction when the aggregate cost of any such work or improvement will be
Five Thousand Dollars or more.
I
These statements to be submitted under oath by each bidder with and as a part of
his bid, as provided by Chapter 305, page 1248, Acts of 1947.
Submitted
...............................................................-~................................................................~........................~..
By ...p..~~...~.~~..~.~.~.~.::.~...~~.~.~~.~.~.~.~.?...~~.:..:....~~:.:.............................. { ~~~~~
~Mti1
Address .._~.?f...~...9.~9:...?~y....~}.~........................................................................... ......................... ........
....~.~~E!::~~ ~.~.~~.:....~.~...~.?~.~.?........................................................................ ........................
Date submitted................ ..................9.~.~.~ .I?~.E...~.Q..........................................
2003
Filed
..........~.._............. ................................. ............................................................
......................................................................................................................
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..... ... ........ .......... ................. .:................ ~.. ~...... ............... .~.......~..... ....~...........~..
A.E. BOYCE. MUNCIE, !ND
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B-107
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j P rinci pal Office at ..J.~~.~...9.~.~...~~!.....~~.~..............,..........,............................................................................................................................................
(\. i Clarksville IN 47129
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EXPERIENCE QUESTIONNAIRE
_ The signatory of this questionnaire guarantees the truth and accuracy of all statements and of all answers to
. interrogatories hereinafter made.
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How many years has your organization been in business as a general contractor under your present business name?
.........:?~...y.~.?!.~.....................................................................................................................................................................................................................
How many years experience in construction work has your organization had (a) as a general contractor; and (b)
as a su bcontracto r? ...J.?2...};?...y~.?.!.~.........~.1?.?....~.?....Y..~~E.~.............................................. ................................................................. ....... .......
What. projects has your 0 rganization completed?..........................................................................................................................................
CONTRACT AMOUNT CLASS OF WORK WHEN COMPLETED NAME AND ADDRESS
OF OWNER
.
1,117,004.88 Sanitary Sewer 09/2001 City of Jeffersonville
.............................................................................. .................................................................................... ............................................................................... ...................................................................n....
439,972.62 Street Reconst 09/2001 City of New Albany
... .... .... ...... ................ ..... ....... ~~ ....~.~..~.. ~~ ...... ..... . .....~.......... ......... ~.... ~.~.. ..................... ~.. ......... ..........................~..~...~....................................... ............................................ ......~............... .....
65,900.56 Excavation 03/2003 City of New Albany
What projects does your organization now have in process of construction?
C0NTRACT AMOUNT CLASS OF WORK WHEN COMPLETED NAME AND ADDRESS
OF OWNER
............ ..Yt.? J..?.9. ~.:. .9.9. ............ ......... Subdivision In process Aberdeen LLC
..............~.~.......................................... ................... ................................................................... ..................................................................
....... ..... ...7..?.9..~ .Q.9.9.:..Q~.... ......... ......... Subdivision In'.'process Robert Lynn Co
.................................................... ...~~~........... .....~.................................. ....................................... ............................................................................
203,630.00 Sanitary Sewer In process SDR Developers
Have you ever failed to complete any work awarded to you? If so, where and why.
...... .............J~I.Q.... .......... .... ...... ..... ...... .............. ............... ......................... ........ .................. ..... .............. ........... ............. ............. ....................... .......................
.................................................................~.. ..................................................................r................................................................. ............... ...........................................................:-..............................
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failed to complete a construction contract? If so, state name of individual, other organization and reason therefor.
.....................N!=?............................................................................10..........................................................................................................................................
...................... .................................................................................................................~..........................................................................................................~..............................................................~..~.........
Has any officer or partner of your organization ever failed to complete a construction contract handled in his/her
own name? If so, state name of individual, name of owner and reason therefor.
.....................N9.........................................................................................................................................................................................................................
I~.;h~~..;~h~;..ii~~.~..;{.b~~i.~~.~~..~;~.y;~.fi;~~~.i~liy.i;.~~;~~~~~i"?........................................................................... ....................................
Ea.rth F:lrstof Kentuckiana, Inc. - Sale of building materials, dirt & mulch
...... ..................... ................... ........................................................r...... ....................................................................................... ............... ...............................
Gotta Go Inc. - Trucking
........ ...e...........~. .~....~. .~.~ ~.... .... ,.:~...~. .............. ....... ........... ~.~...'......... ......... ....... ... ....... .:~.....~. .............. .......... .... ... ...... ..... ........... ....... ................... ................. ..... ~...~.. ~.................... .~............. .......... ~~... ~.... .
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For what corporations or individuals have you performed work, and to whom do you refer?
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;.~.~.~~.~E~.~...Q~y.~).<?P.1,1;l.<:.~.~...!:.~.9..~....?Q.2...~E.i.g...P.E.,.../.~!J~E.?Qg.Y..i.U.~.t....P:1...~7.J.:?Q,..........G.r.~.g...L.ander...................................
: 21 s E....9.!:.g.!:~EY....P..~Y.~J9.P..~I.~.l....~.Q?:.Z...W.9..+.LJ,..?.\<;g..J?1y.fl.1...~g.W...A!J??.ny..1....IN...{j..7..15.0...........Gr.e.g...F.ur.uish...........,...........
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.....~.~~.Y....~.~...~.~.~.~.~E.~.~~::.~J..~.~...:....l?~.~...~L~.~.<:.??......,.........................................................................................................................................
. .....~.~.~.Y....9.~...~.~~...~.~!?~p.y..,.t::.J.'?1?n...~9..f?~.n!?e.:r.g~.:r...,............................................................................................................................ ..... ........
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F~~.:;h;~..~~~.;~i.~;.h~~~.y;~.p~d~.;~~d.:;~~k..~.~f.~~.:;.h~~.d~..y~~..;~f~.;?...............,....................................................................
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None
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13 What is the construction experience of the princIpal individua s of your organization?
I PRESENT YEARS OF
INDNIDUALS POSITION OR CONSTRUCTION MAGNITUDE AND IN WHAT
NAME OFFICE EXPERIENCE TYPE OF WORK CAP ACITY
. .. . Sm~ll-large;water, Laborer, driver,
.p..~~...~...9E~.~.~.~.<::~.~......... .~::.::.~.~.~.::~~......................... ...........~.~................................. .~.~~~~;ry.!.?~~~t~~.~!2':&.~ ...?I?~E~.~.???,...J.~E~.~~g...
Leo Messmer General Mgr 31 Same Same
............................................................................. .......................................................................... ................................................................... ................................................................... ..........................................................
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Allen Jackson
40
Same
Same
Foreman
............................................................................. ................................................................... .......................................................... .................................................................. ................."...................................
Richard Baker Foreman 25 Same Same
........................................ .... ...... ........... ................................. ..... ...... ........................................... ......................... ......................n::L~.b~~.~-;;.~.. 'Op'~ -;; ~.t;;~.~.
Chris Tisheuar Dispatcher 30 Same Driver
.............. .......................... ....... ... .................... .............. n............. ....... .................................. ........ ............. .............................. ...... .. L~'b;; ~.~:;:.;...;; p'~~' ~'t;;~';'
Dale Graf Estimator 10 Same foreman
.................................................. ............................... .................. ............................ ..................... ...................... ............ ............... ..L~.b~~.~-;;.~...;;p.~;;.~.t;;~.~.
Jim Dethy foreman 40~ Same foreman
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C,ISydn'Y1.,.Iocslmi.ccllaneouolm..lcrldivB.wpd
B-109
signatory of this questionnaire guarantees th~ truth and accuracy of all statements and of all answers to
f interrogatories hereinafter made.
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'ln what manner have you inspected this propos~d work? Explain in detail.
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Lay pipe "'
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. Seed & straw '
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PLAN AND EQUIPMENT QUESTIONNAIRE
................. .................................................................................... ....................~................................................................................................................................... ..................
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E.~pf;i~.y~~;.pf;~..;;T~y.~~~.f;;.p~d;.;~i.~.g.~h~.p~~p;.~.~d..;;A~:..........................................................................................................
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Blast .
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Th~.;~~k:..i{~;~;d.~d""~.~..y~~:..;ili""h.;~~..~.h.~.p~~~;.~;C~.~pe~i.;i;.~..;T;.h~~?................................................................................
.................~J.~.'?g....J.~.~.~!?9.TI...............................................................................................................................................................................................
*...D~.y~~.i~t~~d"t~..d~.~he..h~~ii~g.~~.the..p.;~p~;~~f;~~k.;i~.h..y.~~..~;~."f;~~~.~?."i{~.~.:.gi~~.~~;~~~.~~d"typ~"~f
equipment to be used.
Yes triaxles and single axle dump trucks
...... ................to.... ....... ........... ........................ ....... .......................... r.......... ......... ....... ........................ ............... .................. ... ......... ........... ..... ............................
*...i{y~~.i~t~~~f~~..~~bi~t.~h~.h~~ii~g.~~.ped;.;~ri~.th~~~gh'~.~g~~~.:.;~.;~~..;~~~~t""~{;~b~~~~;;;;.;.;.~g~~t.~~~~~~~
and, if known, the name and address of subco~tractor or agent, amount and type of his equipment, and financial
responsibility .
N/A
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Yes
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* If you intend to sublet the grading or perform. it through an agent, state amount of subcontract or agent's
~ontract and, if known, the name and address of subcontractor or agent, amount and type of his equipment and
financial responsibility. .
N/A
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name and address of the subcontractor, amount and type of his equipment and financial responsibility.
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....... . . . .. . - -I .
Kruer Seeding, Floyds Knobs; IN; Libs Paving, Floyds Knobs, IN; Kiesler Electric, Greenville
.ii.~~.t'i:;;g.~...F.~~~.~.;....T~.;;i~.~.."B~.ii'd.~;.~.;....s~i'i~.;t;~.~.;g.:....iN..................................................................................................................
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F;.;~.;;hi~h..;~b~~;~~~~;~;.;;.;g~;~~..d~..y;~..~~p~~t"'~.;..;~q~i;~..~.b;~"d'?........................................................................................
None
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wh~~..~~~i~.~~;~.d~..~~.~..~:;.~..~.h.~~..i~.~~~ii~b'f~.f~Fth~..~;~~;;~d.;;~.~k~............................................................................................
DESCRIPTION,
SIZE, CAPACITY, CONDITION
ETC.
QUANTITY
ITEM
YEARS OF
SERVICE
PRESENT
LOCATION
I .............~.......................... .~~.~~~.~.~.~................. .:!.!?..}~.~~......................... ........~~.?~...................... ..............~........................ y.~E~.?.~~...j9.~.~.~.~.~~
........... ..?....... ................... .~~.~.~.~.?.~.~.~.~............ .~.~.~.~....~??...~?.~~.~.~.~. ........~.??.~..................... ..............?:::?2................ y.~.:.~.?.'!..~..j9.~.~..~.~.~~
I..~ ...~.~....................... ~?::~.~::.~.~~.::.~............ ..?~.~.~....~!??....~~~~.~.~.~. ......J?~.?~...................... ..............~.-..:~............... .... Y.~!:.~9.~.?...t?.~.~.~.~.~.?.
.,
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I 13 Loaders various good 1-12 Various Jobsites
. ........................ ................. . ................ ..................... ................... .................... ..... ................................... ..... ........................................ .................... ......................
9 Scraper pans various fair-good 2-25 Various jobsites
...................................................................................................... .................................................. ............................................... .............................................. ............................................
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5 Rollers var~ous good 2-8 Various jobsites
............................................................................................................... .................................................... .............................................. ............................................... ..............................................
45 Triaxle dumps various good 2-10 Various
...................................................................................................... .................................................... ............................................. ................................................... ..............................................
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C'ISydneylwpJocs\m;.cellaneouslmasl..ldivB .wpJ
B-111
................................................... ................................................. ................................................................................................................................................................ ............................................
112.. How and when will you pay for the equipment purchased?
N/A
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-'13. i5~.y~~.p;~p.;~~..~;..~~~~..~;;y.~.q~ip~~~~..f;;..a~i;.;;~k?..i{~~:..~~~~~.~yp~~..q~.~~~i.ry..~~~r;~~~~~~..f;.;..;~;;~i;;g..................
No
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114.
Have you made contracts or received firm offers for all materials within prices used in preparing your proposal?
Do not give names of dealers or manufacturers.
Yes
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........ ........ ...... ......... ..... ................ ......... ............ ..................... ........... ........... ..... .............. ......~... ... ......... ......... ........ ............... ............. ..... ......... ..................... .................... .... ... ....... ............ .......... ........ ............
I Dated at .....~.~.~E~~.~.~~.~.~.L..~~.................this ..............J~.~~........................day of .........?~.~~.?.::::........................................ 20..QJ...............
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Dan Cristiani Excavating Co., Inc.
.................... ..... ........ .............. ..(N;;;;~.~.l(),:g~~i;;,;~i~~). ........................................... ....
1'1
P esident
<<:...... ................. ............ ............. ................. .............. .... .-.... .....................
(Title of Person Signing)
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STATE OF .........J~~~.~~~.........m............... )
) 55:
COUNTY OF...........~.~.~~.~................................ )
! ........................................p.~.~...~.:....~E.~~.~.~~.~.~.................................:.............being duly sworn, deposes and says that he is a member of
.. D.in Cristiani Excavating Co., Inc. .. and that the answers to the questions in the foregoing
.........................................................................................~.....................,;.....................................'.............. . . .. .
(Name of Organization)
questionnaire and all statements therein contained are true and correct.
{,s~l'?ffribed and sworn to me this......................?9.~~...........;.............day of ..............~.~!-.~.I?~E.....................................20 ~}................................
, -orrunission expires .mu..m..l_~_~~_3.:::~.O'_O'~m.....m.m..u..'...um.m ,~'1YI . ~
Lisa . Eddleman
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B-112
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BALANCE SHEETS
December 31, 2002 and 2001
DAN CRISTIANI ,EXCAVATING CO., INC.
!
ASSETS
CURRENT ASSETS
Cash
Contracts receivable, net
Miscellaneous receivables
Receivable from affiliates
Costs and estimated earnings in excess Of billings
Inventory
Prepaid expenses
Notes receivable
TOTAL CURRENT ASSETS
PROPERTY AND EQUIPMENT
Construction equipment and vehicles
Leasehold improvements
Office equipment
Less accumulated depreciation
PROPERTY AND EQUIPMENT, NET
OTHER ASSETS
Deposit on equipment
Investment in subsidiary
TOTAL ASSETS
LIABILITIES AND STOCKHOLDER'S EQUITY
CURRENT LIABILITIES
CUrrent portion of long-term debt
Current portion of capital lease obligation
Accounts and contracts payable
Accrued payroll and payroll taxes
Accrued expenses
Accrued interest
Accrued built-in gain taxes
Billings in excess of costs and estima~ed earnings
Deposits
Deferred income
TOTAL CURRENT LIABILITIES
Long-term debt, less current portion
Capital lease obligation, less current portion
TOTAL LIABILITIES
STOCKHOLDER'S EQUITY
Common stock; 1,000 shares authorized; no par value;
100 shares issued and outstanding
Retained earnings
TOTAL STOCKHOLDER'S EQUITY
TOTAL LIABILITIES AND STOCKHOLDER'S EQUITY
2002
$ 342,736
1,993,285
124,218
198,439
30,093
14,454
2,703,225
6,658,864
39,199
66,939
(3,768,186)
2,996,816
3,000
$ 5,703,041
$ 688,597
82,060
873,976
71,433
44,178
2,708
14,640
32,096
19,049
1,828,737
821,214
109,550
2,759,501
12,093
2,931,447
2,943,540
$ 5,703,041
See notes to 'financial statements.
2
2001
$ 672,023
2,231,359
11,209
44,775
33,733
220,780
25,789
3,239,668
5,680,784
41,769
87,641
(2,970,755)
2,839,439
7,929
$ 6,087,036
$ 718,236
37,328
1,112,009
64,592
27,696
4,177
60,086
200,000
2,224,124
758,020
65,659
3,047,803
12,093
3,027,140
3,039,233
$ 6,087,036
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DAN CRISTIANI EXCAVATING CO., INC.
STATEMENTS OF INCQME AND. RETAINED EARNINGS
for the years ended .December 31, 2002 and 2001
REVENUES
Construction and excavating
Trucking
Administrative fee income
2002 2001
$ 10,330,386 $ 12,860,760
1,698,863 1,221,499
273,600 264,000
12,302,849 14,346,259
2,488,720 2,295,421
3,460,201 3,579,154
2,339,901 4,087,486
1,063,268 958,367
439,927 503,544
242,132 178,717
252,329 314,377
534,109 750,508
23,704 23,273
23,447 51,769
201,624 186,480
73,499 54,987
98,750 128,217
39,589 34,726
11,281,200 13,147,026
1,021,649 1,199,233
584,747 701,921
62,501 60,306
66,375 84,855
67,550 51,850
35,608 38,766
40,479 48,553
58,348 24,815
47,447 48,387
5,866 10,110
12, 844 11,912
4,039 20,122
51,070 45,658
5,249 6,149
21,850 15,843
10,441 12,679
14,289 12,019
21,258 45,778
1,109,961 1,239,723
(88,312) (40,490)
TOTAL REVENUES
DIRECT COSTS
Wages
Materials
subcontractors
Depreciation and amortization
Repairs and maintenance
Insurance
Gas, oil and fuel
Equipment rental
Permits, bonds and plans
Landfill fees
Payroll taxes
Trucking costs
Interest
Employee retirement
TOTAL DIRECT COSTS
GROSS PROFIT
OPERATING EXPENSES
Salaries
Insurance
Office expense, supplies
Rent - building
Telephone and utilities
Payroll taxes
property taxes
Legal and professional fees
Depreciation and amortization
Administrative fees
Bad debts
Advertising and dues
Travel and entertainment
Uniforms
Employee retirement
Miscellaneous taxes and licenses
Contributions
TOTAL OPERATING EXPENSES
LOSS FROM OPERATIONS
See notes tal financial statements
3
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DAN CRISTIANI 'EXCAVATING CO., INC.
STATEMENTS OF INCOME AND,RETAINED EARNINGS
for the years ended December 31, 2002 and 2001
LOSS FROM OPERATIONS
2002
(88,312)
3,251
2,220
110,819
116,290
27,978
(45,645)
(78,026)
3,027,140
$ 2,931,447
OTHER INCOME
Miscellaneous income
Interest
Gain on sale of equipment
TOTAL OTHER INCOME
NET INCOME
Distributions
Liquidation of subsidiary
RETAINED EARNINGS, beginning of year
RETAINED EARNINGS, end of year
See notes to ~inancial statements
4
2001
(40,490)
7,932
9,980
36,017
53,929
13,439
(136,260)
3,149,961
$ 3,027,140
.:oration, answer this:
Of' fo r w hi ch in co rp 0 rated .............. ..... .......... .................. ..... ........ ........ ........ .................... ........ ............ .............. ............. ....... .... ........ ....... .......~.....
'tal paid in cash ........ ................... ..... ...... ......... ..... ....... ..... ........ .... ................. ......... ..... ..... .................. .......... $ .. .......... ............. ................. .... ......... .........
{~~,f~~}nco rp 0 rated ........ ...... ...... ....~.~. ?.~............. ....... ............ ............ ......................... ............ ................ ........ .-................ '" ........... .............. ...... .... ...............
I ~f~.~~t state ....... ......................... .....:);g~J.~g.~...............................:....................... .................................................................................................................
.:$!~i(.
I ~~,~~,", ',an, . d titles. of all persons having authority to execute and receipt estimate ,:,ouchers and to conduct other business
f6ftij~,.corporat1on, IncludIng Its officers, the SIgnatures of whom are legally bmdIng.
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l..~....;.........::..~.~.~::........................................................................................l........................................................................................................................................
Q'6you h~ve the necessary "certificate of authority" t~ transact corporate business in this state, under the terms of
I~',:;r 215, Acts of 1929, and acts amendatory thereto? .......:'.~.~.................................................................................................................
Ifaco-partnership, answer this:
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I ~~1~:9f. 0 rganizati on... .... ......... ......... .......... ......... ............,. ...... .... .... ....... ... ...... .... .... ...... ..... ............ ...... ......... ... ... .... ... .............. .... ... .......
State whether co-partnership is general, limited or association .......................................................................................................................
names, addresses and proportional interests of all parties...............................................................................................................
NAME
ADDRESS
SHARE
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C,ISydneylwpdocslmi.cellancouslma'lcr\divB.wpd
B-118
name of the partnership firm under which the above partners are operating is.........................................................................................................
~~ ' '~
',. .. Iye.riirii~.~.d.~i~i~.;.f.ill.p~~;.~~.h~;~g.~~~h;.ri~y.~-;.~;~.~-;;~~.~~r~~~~ip~.~~i~~~~-;;-~~h~~.~d.~~.~~-;;d~~..~~h~;.b-;;~i-;;~~..f~~.~h~.p;;;;~~~hip;
I~~~ignatures of whom are legally binding.
r~.~..t"::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
I....... ........ .'. .... ...................... ........ ........ ............. ...... .................... ............ .......... ........................ .................... ...... ........ ......... ........ ................ ........... ................. ............. .....
Th~.-;;;d~rsigned hereby declares that the foregoing is a true statement of the financial condition of the individual, co-partnership or corporation
herein first named, as of the date herein first given; that this statement is for the express purpose of inducing the party to whom it is submitted
I. t:Oirward ~he subm~tter a contract; and :hat ~ny depository, vendor or other agency herein named is hereby authorized to supply such party
with any mformatlOn necessary to venfy thIS statement.
NOTE: A co-partnership must give firm name and signature of all partners. A
I corporation must give full corporate name, signature of official and affix
I corporate seal.
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Affidavit for Individual
1:~t~fE OF .............................................. )
;!~'~icE;i;i ) 55:
I"CO~TY OF ........................................................ )
~......:.;...........................................,........,....,..~................u,....................~...L.....being duly sworn, deposes and says thereof that the foregoing financial
lil~~lt;:,=;:::::'t~:.tcue andaccume ",,,meht of h~ fioanciol conwtion .,.:~.t~:..~::.~::.=f.~.:.~:t..'::.=:=..t:....
!!~iWi! (Applicant must sign here)
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Affidavit for Co-Partnership
'EOF
......................................... ............... )
) 55:
.......... ...... ............ ...................... ...... )
I COUNTY OF
...........................................................................................................................being duly sworn, deposes and says that he is a member of the firm of
I ~-;~~~i~~;.~h~~.~h~.f~~~g~i~g.fi~~;;~iJ..~~~~~~~~.:.~~k~~..f~~~~h~.b.~~k~~/;~~ ?~~,f~s~i~:e :~~ ~~~u~~t~~:~~:~~:i~Tt~~~:~:gcf~~ ~::~i~~~ln
of s~d fIrm as of the date thereof and that the answers to the foregoing interrogatories are true.
I Subscribed and sworn to me this......................................day of ...................... 20 ...............
(Member of firm must sign here)
............... ...................... ....... .....N.~~~ry.P-;;bii.~..... ........... .................. ...... .........
I
Affidavit for Corporation
STATE OF
I COUNTY OF
.........~EJ:~.~~~.~............................. )
) 55:
.........~.~.~.::~................................... )
f ..................................P..?g...I~....y.E.~.~.~.~.~~.~.......................................being duly sworn, deposes and says that he is a member of the corporation of
....p..9-.u..J;;.Ei!?ti:?:~.t.:..~.?5?~.y.~.~.~~~...~.~.=.L...~~E.:..................... described in and which executed the foregoing statement; that he is familiar
WIth the. bo~ks of saId corporation showing its financial condition; that the foregoing financial st~ t, taken from the books of said
corporatlOn 1S a true and accurate statement of the financial condition of said corporation as of l1'e date e the answer to the
I foregoing interrogatories are true. . .
ere)
r~if 'ib"1m ,!,om cWl1 me ]!1';"zr:Jg.~~................... day of.g.".~.9.~~.F..... 20 .QJ.........
..............~..l......:;.~........................
Li'sa M. Eddlema~otary Public
My Commission Expires: 10-13-2006
C,l,Sydney\wpdocs\mi.cell.neow\m..ler\divB'''lJ
B-119