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FIRST-TIER SUBCONTRACTOR DISCLOSURE STATEMENT <br /> .Project Title: 2009 Pavement Preservation Program on Country Club Rd <br /> from. Wihagillespie Rd to .Southwood Ln -Job #4425, Fox <br /> Hollow Rd from East Amazon Dr to Donald St -Job #4434, <br /> Crescent Ave from Shadow View Dr to Coburg Rd -Job #4502 , <br /> City of Eugene Project No. 4425, 4434, 4502 ; <br /> . Bid Closing: Date: April 2, 2009 Time: 2:00 p.m. <br /> Submit to: 99 E. Broadway, Suite 400, Eugene Oregon 97401 <br /> Disclosure Deadline: 2:00 p.m. -This form must be submitted by bid closing date and <br /> time. - <br /> <br /> Bidders are required to submit a first tier subcontractor disclosure form, substantially as described iri <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 /> <br /> BIDDER INFORMATION <br /> Bidder's Name: WILDISH CONSTRUCTION CO. <br /> Contact Person: JOE WORTH <br /> Bidder's Telephone Number: 5 41- 4 8 5-17 0 0 <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 riot 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 of Work <br /> ~(nZ T~l.SS«,,, s~ ~ ~4ycvy <br /> wyc~.~ C~~ ~TY~S' <br /> 2) . <br /> 3) <br /> <br />