New Search
5~ <br />I-.. <br />FIRST-TIER SUBCONTRACTOR DISCLOSURE STATEMENT <br />Project Title: Pavement Bond Measure on Willamette Street from 46d' <br />Avenue to 52nd Avenue <br />City of Eugene Project No. 4582' <br />Bid Closing: Date: April 1, 2010 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 <br />and time. <br />Bidders are 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 />f € <br />Contact Person: <br />1 ~E O NG CV ~ wd <br />1 1-1 4, <br />Bidder's Telephone Number: <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 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 />~ r~~I ~ ~ ~"J.PJU!i1 ~IL~ ~L ~ J w' tea'? r •~'/►~v9~~ <br />2) ~P P1 "41ir y_WZ9 NAaZl~14A► <br />_r1J bt_A_ 1N e vi?-. 0712bz- <br />3) 07-1 0,16-e-7pe- t -7 3 <br />~ ZZ~,n r 5~7. S~ ~ l~bP <br />5,~? . vii . °C73oZ <br />