HomeMy WebLinkAboutBid FormCONTRACTORS BID FOR PUBLIC WORKS
PART I
(To be completed for all bids)
(Please type or print)
Form No 96 (Revised 2000)
Date:
1. Governmental Unit (Owner):
2. County:
3. Bidder (Firm):
Address:
City/State:
4. Telephone Number:
5. Agent of Bidder (if applicable):
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the
public works project of
(Governmental Unit) in accordance with plans and specifications prepared by
and dated for the sum of
$
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the
notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the
notice. Any addendums attached will be specifically referenced at the applicable page.
If additional units of material included in the contract are needed, the cost of units must be the same as that
shown in the original contract if accepted by the Governmental Unit. if the bid is to be awarded on a unit basis,
the itemization of the units shall be shown on a separate attachment.
The Contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee, or
applicant for employment, to be employed in the performance of this contract, with respect to any matter directly
or indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this
covenant may be regarded as a material breach of the contract.
CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS
(If applicable)
I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory obligation
to use steel products made in the.United States. I.C. 5-16-8-2. I hereby certify that I and all subcontractors employed
by me for this project will use U.S. steel products on this project if awarded. I understand that violations hereunder
may result in forfeiture of contractual payments.
SECTION II CONTRACTOR'S FINANCIAL STATEMENT
Attachment of bidder's financial statement is mandatory. Any Did submitted without said financial statement as
required by statute shall thereby be rendered invalid. The financial statement provieded hereunder to the govermng
body awarding the contract must De specific enough iq detail so that said governing body can make a proper
determination of ~ne bidder's capability for completing ~ne project if awarded.
SECTION IV OATH AND AFFIRMATION
I hereby affirm under the penalties of pedury that the facts ana information contained n the foregoing bid for
public works are true ana correct To ~ne best of my knowledge and belief,
Dated at this day of.
(Name of Organization)
By
(Title of Person Signing)
ACKNOWLEDGEMENT
STATE OF
)
COUNTY OF )
_being duly sworn, deposes and says that he is
of the above
(Titlet · Name of Organiza. tion)
and that ~ne answers to the questions in the foregoing questionnaires and all statements therein contained are
true and correct.
Subscribed and sworn to before me this
day of
My Commission Exoires:
County of Residence:
Notarz Public
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The above bid is accepted this
following conditions:
ACCEPTANCE
day of
, subject to the
Contracting Authority Members:
PART II
(Complete sections MI,Ill, and IV for all state and local public works projects as required
by statutes if project is one hundred thousand dollars ($100.000) or more. (lC 36-1-12-4)
Governmental Unit:
Bidder (Firm)
Date:
These statements to be submitted under oath by each bidder with and as a part of his bid.
Attach additional pages for each section as needed.
SECTION I EXPERIENCE QUESTIONNAIRE
1. What public works projects has your organization completed for the period of one (1) year prior to the date
of the current bid?
When Name and Address of Owner
Contract Amount Class of Work Completed
2, What public works projects are now in process of construction by your organization?
When to be Name and Address of Owner
Contract Amount Class of Work Completed
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