DOLLAR AMOUNT: $ DATE COMPLETED: PUBLICLY BID? YES NO TYPE OF WORK?: TELEPHONE #: ) CONTACT PERSON: CONTACT PERSON'S RELATION TO PROJECT?: (i.e., contract manager, purchasing agent, etc.) PROJECT NAME: OWNER: CITY/STATE: DOLLAR AMOUNT: $ PUBLICLY BID? DATE COMPLETED: TYPE OF WORK?: YES NO CONTACT PERSON: TELEPHONE #: ( ) CONTACT PERSON'S RELATION TO PROJECT?: (i.e., contract manager, purchasing agent, etc.) PROJECT NAME: OWNER: CITY/STATE: DOLLAR AMOUNT: $ PUBLICLY BID? DATE COMPLETED: TYPE OF WORK?: YES NO CONTACT PERSON:_ TELEPHONE #: ( ) CONTACT PERSON'S RELATION TO PROJECT?:_ (i.e., contract manager, purchasing agent, etc.) PROJECT NAME: OWNER: CITY/STATE: DOLLAR AMOUNT: $ PUBLICLY BID? DATE COMPLETED: _ TYPE OF WORK?: YES NO CONTACT PERSON: TELEPHONE #:( ) CONTACT PERSON'S RELATION TO PROJECT?: (i.e., contract manager, purchasing agent, etc.) 10. The undersigned certifies that the information contained herein is complete and accurate and hereby authorizes and requests any person, firm, or corporation to furnish any information requested by the City in verification of the recitals comprising this statement of Bidder's qualifications and experience. BIDDER: DATE: SIGNATURE: PRINTED NAME: TITLE:
DOLLAR AMOUNT: $ PUBLICLY BID? YES NO DATE COMPLETED: TYPE OF WORK?: CONTACT PERSON: TELEPHONE #: ) CONTACT PERSON'S RELATION TO PROJECT?: (i.e., contract manager, purchasing agent, etc.) PROJECT NAME: OWNER: CITY/STATE: DOLLAR AMOUNT: $ PUBLICLY BID? TYPE OF WORK?: YES DATE COMPLETED: NO CONTACT PERSON: CONTACT PERSON'S RELATION TO PROJECT?: TELEPHONE #: ( ) (i.e., contract manager, purchasing agent, etc.) PROJECT NAME: OWNER: CITY/STATE: DOLLAR AMOUNT: $ PUBLICLY BID? TYPE OF WORK?: YES DATE COMPLETED: NO CONTACT PERSON:_ CONTACT PERSON'S RELATION TO PROJECT?:_ TELEPHONE #: ( ) (i.e., contract manager, purchasing agent, etc.) PROJECT NAME: OWNER: CITY/STATE: DOLLAR AMOUNT: $ PUBLICLY BID? TYPE OF WORK?: YES DATE COMPLETED: _ NO CONTACT PERSON: CONTACT PERSON'S RELATION TO PROJECT?: TELEPHONE #:( ) (i.e., contract manager, purchasing agent, etc.) 10. The undersigned certifies that the information contained herein is complete and accurate and hereby authorizes and requests any person, firm, or corporation to furnish any information requested by the City in verification of the recitals comprising this statement of Bidder's qualifications and experience. DATE: BIDDER: SIGNATURE: PRINTED NAME: TITLE:
fire-alarm-maintenance.docx