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r <br />FIRST-TIER SUBCONTRACTOR DISCLOSURE STATEMENT <br />Project Title: Tree Removal -River Avenue <br />City of Eugene Project No. 3693 <br />Bid Closing: Date: Time: 3:00 p.m. <br />Submit to: 244 E. Broadway, Eugene, Oregon 97401 <br />Disclosure Deadline: 3 :00 p.m. -This form must be submitted by quote closing date <br />and time. <br />For this project, the First-tier Subcontractor Disclosure Statement must be submitted regardless <br />of the bid amount. <br />BIDDER INFORMATION <br />Bidder's Name: <br />Contact Person: _~1~~~„~ ~~ ~y1rv~ <br />Bidder's Telephone Number: ~~sti1~ ~(~~ - ~~-~~" <br />[Yl Check here if the bid amount less deductive alternates, if any, is $100,000 or less. If the bid <br />amount less deductive alternates, if any, is equal to or less than $100,000, the remainder of the <br />form does not need to be completed, but the form must still be submitted. <br />List below the Name, Dollar Value, and Construction Contractors Board ("CCB") License Number, <br />and Category of Work that will be performed by each subcontractor that will be furnishing labor, or <br />labor and materials. Enter "NONE" if there are no subcontractors that need to be disclosed (IF <br />NEEDED, ATTACH ADDITIONAL SHEETS). <br />_ Name/Address Dollar Value/CCB# Category ofWork <br />1). ~~ ~ '~~ . C'o: Ct~ alb ?~~ ~"~ ~e•nCe. rew~~,~ ~i wo~a l~a~b.n <br />~~g ~ 3,5'~ ~ ~' S S~ S. ao <br />5 <br />2) <br />3) <br />