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FIRST-TIER SUBCONTRACTOR DISCLOSURE STATEMENT <br /> Project Title: Walnut Grove Park Phase 2 <br /> City of Eugene Project No. 4645 <br /> Quote Closing: Date: August 28, 2009 Time: 3:00 p.m. <br /> Submit to: 99 E. Broadway, Suite 400, Eugene Oregon 97401 <br /> Disclosure Deadline: 3:00 p.m. -.This form must be submitted by bid closing date <br /> and time. <br /> Quoters are required to submit a first tier subcontractor disclosure form, substantially as described in <br /> ORS 279C.370, prior to the Quote Closing Date and time: For this project the First-Tier <br /> 3ubcontractor.Disclosure Statement must be submitted regardless of the quote amount. <br /> QUOTER INFORMATION <br /> Quoter's Name: 2G Inc. , dba 2G Construction <br /> Contact Person: Frederick J. Viscardi, Jr. , President <br /> Quoter's Telephone Number: 541-689-3850 <br /> heck here if the uote amount less deductive alternates if <br /> q any, is $100,000 or less. If the <br /> ;quote amount less deductive alternates, if any, is equal to or less than $100,000, the remainder <br /> of the 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 /> 1) <br /> <br /> 2) <br /> 3) <br /> <br />