New Search
FIRST-TIER SUBCONTRACTOR DISCLOSURE STATEMENT <br />Project Title: 2008 Pavement Preservation Program - Roosevelt Boulevazd <br />from Beltline Highway to Chambers Connector <br />City of Eugene Project No. 4479 <br />Bid Closing: Date: August 27, 2008 Time: 2:00 p.m. <br />Submit to: 244 E. Broadway, Eugene, Oregon 97401 <br />Disclosure Deadline:: 2:00 p.m. -This form must be submitted by bid closing date <br />and time. ` <br />Bidders aze required to submit a first tier subcontractor disclosure form, substantially as described in <br />ORS 279C.370, prior to the Bid Closing Date and time. For this project the First-Tier <br />Subcontractor Disclosure Statement must be submitted regardless of the bid amount. <br />BIDDER INFORMATION <br />Bidder's Name: <br />Contact Person: (~-'1 i~C-t . I~rva~ts~~,~O~c~. <br />Bidder's Telephone Number: („ ~ 3 - ~ ~'-~ ~ <br />^ 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;Boazd ("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 Dollaz Value/CCB# Category of Work <br />1) , ~ ~ ~~~,~d~~ ~~/;~r~',, 100 ~0~ <br />2) <br />3) <br />