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FIRST-TIER SUBCONTRACTOR DISCLOSURE- STATEMENT <br /> Project Title: Delta Ponds Path - Goodpasture Island Road to Robin Hood <br /> ~ Avenue <br /> <br /> ' City of Eugene Project No. 4378 <br /> ' Bid Closing: Date: June 24, 2009 Time: 2:00 p.m. <br /> Submit to: 99 E. Broadway, Suite X00, Eugene Oregon 97401 <br /> Disclosure Deadline: 2:00 p.m. -This form must be submitted by bid closing date <br /> and time. <br /> ,Bidders are required to submit a first tier subcontractor disclosure form, substantially as described in <br /> ORS ~ 279C.37.0, 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: Mowat Construction Company . <br /> Contact Person: Jeff Holliday <br /> Bidder's Telephone Number: 503.650.5389 . <br /> Q 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 of Work <br /> I~~a~ C~~ ~1~ <br /> z> <br /> 3) <br /> <br />