WPCJ KN/; Re| Ȗ$W6UZ S%bLx]fF\e ZxJUbppU޷ujjܐJ &?(U ih{ѕ!$46Ic0Wkٖ>.t!5 Y"!vpZ 9a]rJ<dž%p*Yb21:S5yŹƦq+B"3l[(jQh@P2$M>SaX?:J ,@kꓝgCQ5pdX2\plc*YjKU*h>f<_pB4q5eiM[3dan7E9}ŚVm!ڴr0 Ɉ=_B%vsHW 9A%x;:%nb}$k}*}x_S 0U/<|U(]  B D3  0C 0( A;M D+e C f a f a f a f a f a f a f. a0 fD aF fZ a\ fp ar f a f a f a f a f a f a f a f a"f6a8LUN\ %N 0( mUN0A 0D 04gKE  B 9 0:e 0e ' 0g 0gTU2U2UB#we4i#}}}}^ ><uj:Default Para  Q\  `$Times NewRomanQ&&&Q\  `$Times NewRomanQ\  `$Times NewRoman' n NYCTA 0 .   %2A`HelvCheck1 d'dxd Level 1 Level 2 Level 3 Level 4 Level 5(2w$ 8!  ($ A<< c'dxd dTable_ATable_BTable_CTable_DTable_ETable_FTable_GTable_HTable_I Table_J Table_K Table_L Table_M Table_NTable_OTable_PTable_QTable_RTable_S#|x(hH  Z 6Times New Roman Regular5X($UxhH  Z6Times New Roman Regulara, b, c,Level 1Level 2Level 3Level 4Level 5(3$ 8!  6#7^4Quick a. <  .0 <  d1, 2, 3,Level 1Level 2Level 3Level 4Level 54#82Quick 1.A  .0 AI., II.,Level 1Level 2Level 3Level 4Level 54#9V2Quick I.C  .0 Ci., ii., iii.,Level 1Level 2Level 3Level 4Level 56#94Quick i) E  )0 E6#94Quick i. E  .0 E{,h  ZTimes New{,h  ZTimes New  ='  _KXHXX5X =  =  =  KXKXHBestPracticesProcurementManualAppendixB.11BiddersQualificationQuestionnaireG"G"G" $Page  1  #KXHXK#Ԉ X A?)  xdE : A#5XHXXKXHG#\  `*Times New RomanTTS*torisrespoHP LaserJet 5P,,,,,,01u* 8!  _5&B)%X5X5XHX%5&B)  XX  XXX5XH ;XyXXXJAPPENDIXB.11 + NEWYORKCITYTRANSITAUTHORITY  DivisionofMateriel  ProcurementSubDivision  ScheduleJ w L  BIDDER'SQUALIFICATIONQUESTIONNAIRE O $  #XXX;Xy#  ~ _XHXXX PARTIINSTRUCTIONS  +  XB.p x(08"XB     1  a.0 p AllBidders/ProposerssubmittingaBid/Proposalforpublicworkcontracts(IFB&   RFP);personalservice(includingArchitecturalandEngineering)contracts(RFP);  RFPsforsupply,material,equipment(includingtransitvehiclesandrollingstock);  RFPsformiscellaneousprocurementandservicecontracts;noncompetitive/solesource  contracts(includingpreferredsourceandexistingpubliccontracts)equaltoorinexcess  of$10,000aretocompleteandsubmitPartsI,II,III,IVandVIIIwiththeirBidor   Proposal. p $p $   XE14 <DL!T$XE  b. 4 PUBLICWORKCONTRACTS(IFB&RFP)  `   X?+ p x(08"X?0 p IfthisQuestionnaireissubmittedinresponsetoanInformationforBidders(IFB),the k@  apparentlowbidderwillreceivewrittennotificationrequestingsubmissionofPartsV, [0  VIandVII.IfthisQuestionnaireissubmittedinresponsetoaRequestforProposal K  (RFP),andtheproposalsubmittedequalsorexceeds$25,000allProposersareto ; completeandsubmitallPartsoftheQuestionnairewiththeirProposal.+p $p $  XE14 <DL!T$XE<>7^   ! p XX!>7^ <c  .0    PERSONALSERVICEINCLUDINGARCHITECTURALANDENGINEERING   CONTRACTS(RFP)>7^  <ی $ $ Ќ   H14 <DL!T$p XH X?+ p x(08"X?0 p Wheretheproposalsubmittedequalsorexceeds$20,000forapersonalservice  (consultant)contract,allProposersaretocompleteandsubmitallPartsofthe  questionnairewiththeirProposal.p $p $  XE14 <DL!T$XE  ! p XX!d.  RFPsFORSUPPLY,MATERIAL,OREQUIPMENT(INCLUDINGTRANSIT p VEHICLESANDROLLINGSTOCK),ANDMISCELLANEOUSPROCUREMENT ` ANDSERVICECONTRACTS {P   H14 <DL!T$p XH X?+ p x(08"X?0 p Wheretheproposalsubmittedequalsorexceeds$250,000forsupplies,materials,or [0 equipment(includingtransitvehiclesandrollingstock),andmiscellaneousprocurement K  andservicecontractsallProposersaretocompleteandsubmitallPartsofthe ;  questionnairewiththeirProposal.+! p $p $  XE14 <DL!T$XE  ! p XX!e.  NONCOMPETITIVE/SOLESOURCECONTRACTS(INCLUDINGPREFERRED  #" SOURCEANDEXISTINGPUBLICCONTRACTS # #   H14 <DL!T$p XH X?+ p x(08"X?0 p Wheretheproposalsubmittedequalsorexceeds$25,000fornoncompetitivepublic %"% workcontracts,$20,000fornoncompetitivepersonalservice(Consultant)contracts, &#& and$250,000forallothernoncompetitivecontracts,allProposersaretocompleteand '$' submitallPartsofthequestionnairewiththeirProposal.(%(p $p $  XE14 <DL!T$XEA 's#X2.0 ' Pleasestate"notapplicable"inquestionsclearlynotapplicabletoBidder/Proposerin *`'* connectionwiththissolicitation.Donotomitanyquestion.Ifanyrepresentationisnotaccurate {+P(+ andcompleteatthetimeBidder/ProposersignsthisQuestionnaire,Bidder/Proposermust,as k,@), partofitsBid/Proposal,identifytheprovisionandexplainthereasonindetailinthespace [-0*- providedbelow.Ifadditionalspaceisneeded,addadditionalsheet(s)tothisQuestionnaire.If K. +. thisspaceisleftblank,Bidder/Proposershallbedeemedtohaverepresentedandwarrantedthe ;/,/ accuracyandcompletenessoftherepresentationsonthisQuestionnaire:+0-0' $' $  ' _.s#s#Ks#_''  ' s#s#Ks#_''  ' s#s#Ks#_''  ' s#s#Ks#_''  ' s#s#Ks#_''  ' s#s#Ks#_'' " X's#["A 's#XB8  B8A3  .0 '   Allinformationmustbelegible.B8Aی ' $' $ Ќ  4.0 ' CompletedQuestionnairemustbesworntobyapartner(ifpartnership),adulyauthorized  p  officerorindividual(ifacorporation),oraprincipal(ifasoleproprietorship). ` ' $' $ " X's#"AB8   's#XB8 A5  .0 '   Theterm"Proposer"includestheterm"Bidder"andalsoreferstothefirmawardedthe k@  Contract.Theterm"Proposal"includestheterm"Bid".B8 BAی[0 ' $' $ Ќ  6.0 ' IfduringtheperformanceofthisContract,eitherofthefollowingoccurs,Biddershall ; promptlygivenoticeinwritingofthesituationtotheAuthoritysChiefProcurementOfficer, + andthereforecooperatewiththeAuthority'sreviewandinvestigationofsuchinformation.' $' $ F9  X?+ p x(08"'s#?F9Ei  )0 p   Proposerhasreasontobelievethatanyrepresentationoranswertoanyquestion  containedinthisQuestionnairewasnotaccurateorcompleteatthetimethis  Questionnairewassigned;orF9XEیp $p $ Ќ  XE14 <DL!T$XE X?+ p x(08"X?ii)0 p eventsoccurorcircumstanceschangessothatananswertoanyquestioninPartIVisno  longeraccurateorcomplete.p $p $  XE14 <DL!T$XE0  IntheAuthority'ssolediscretion,thefollowingshallconstitutegroundsfortheAuthorityto ` takeremedialactionuptoandincludingimmediateterminationoftheContractforconvenience {P withoutpaymentforprofitandoverheadforworknotperformedif:i)Proposerfailstonotify k@ theChiefProcurementOfficerasrequiredby"6"above:ii)Proposerfailstocooperatewiththe [0 Authority'srequestforadditionalinformationasrequiredby"6"above.K  $ $ AB8  B8#A7  .0    TheAuthorityreservestherighttoinquirefurtherwithrespecttoProposer'sresponses;and +!  Proposerconsentstosuchfurtherinquiryandagreestofurnishallrelevantdocumentsand "! informationasrequestedbytheAuthority.Anyresponsetothisdocumentpriororsubsequentto  #" Proposer'sProposalwhichisormaybeconstruedasunfavorabletoProposerwillnot # # necessarilyautomaticallyresultinanegativefindingonthequestionofProposer'sresponsibility $!$ oradecisiontoterminatetheContractifitisawardedtoProposer.B8#$Aی%"% $ $ Ќ  A@?) dE' A '$'  PARTIIIDENTITYOFPROPOSER  (%) ! p X!% Xp '% s#X1.  Proposer'sFullLegalName:s#s#Ks#_' *'+   s#s#Ks#_   s#s#Ks#_ AB8  B8(A2  .0    TheProposerrepresentsthatitoperatesasthefollowingformoflegalentity:(Checkwhichever j.?+/ appliesandfillinanyappropriateblanks.)B8()AیZ//,0 $ $ Ќ  ! 4s#s#!  %  w C3/Z \ @ H@E w%* 4 anindividualorsoleproprietorship  C  H C   E51Z \ @@E 4 ageneralpartnership  C  HC   E51Z \ @@E 4 alimitedpartnership  C  HC   E51Z \ @@E   4 ajointventureconsistingof:s#s#Ks#_$$/   C  H C   4 ands#s#Ks#_   p  '4 s#4s#'   4  (Listalljointventurersonaseparatesheetifthisspaceisinadequate.)  `  + 4s#4 s#(/+   E51Z \ @@Ep` 4 anonprofitorganization k@     E51Z \ @@EP@ 4 acorporationorganizedorincorporatedunderthelawsofthefollowingstateorcountry: K  C  H;C$ 42s#4s#$ 4 2_ffonthefollowingdate:s#s#Ks#_225 + ( 4s#42A 2(3.  Proposer'sfederaltaxpayeridentificationnumber:s#s#Ks#_?   ! s#4s#!4.  Proposer'slegaladdress:s#s#Ks#_ &    s#s#Ks#_   s#s#Ks#_ % 4s#s#D3%  TelephoneNumber:(____)_________________FaxNumber:(____)s#s#Ks#_I  5.  Proposer'slocalorauthorizedpointofcontractaddress: ` $ s#4s#$  Name: _""Title:s#s#Ks#_( k@ ( 4s#k5(  Address:s#s#Ks#_ K  $ s#4s#$    s#s#Ks#_( 4s#s#6(  TelephoneNumber:(____)_________________FaxNumber:(____)s#s#Ks#_I "!  XE.p x(08"4s#E 6.  a.0 p IfProposerisacorporation,hasaCertificateofIncorporationbeenpreviouslyfiled # # withtheNewYorkCityTransitAuthority?$!$p $p $  %"%   XE14 <DL!T$XE   4 YES E51Z \ @@E & &  < NO E51Z \ @@E&&    Ifansweris"NO",attachacertifiedcopy. &#& <>7^  C  H(%C  >7^X:<b  .0 4   AttachacertifiedcopyoftheByLawsandResolutionoftheCorporationgivingthe (%( namesandtitlesofthecorporateofficersotherthanPresident,aswellasnonofficer )p&) employees,whoareauthorizedtosigncontracts,bonds,billsofsaleandotherlegal *`'* instrumentsinconnectionwiththeContract,ifthesamehavenotbeenpreviouslyfiled.>7^X::<ی{+P(+4 $4 $ Ќ    >7^  XB.p x(08"XB   >7^=<c  .0 p   Ifaforeigncorporation,hasproofofauthoritytotransactbusinessintheStateofNew [-0*- YorkbeenpreviouslyfiledwiththeNewYorkCityTransitAuthority?>7^==<یK. +.p $p $ Ќ   XE14 <DL!T$XE0   4 YES E51Z \ @@E 00 0  < NO E51Z \ @@E00 0     Ifansweris"NO",attachproofofsuchauthority.+0-0 $ $ Ї0  04 $ $?+ p x(08"X?IntheeventthatanyofProposer'sprevioussubmissionstotheTransitAuthorityin + responsetotheabove(questionsac)nolongerrepresenttheProposer'scurrent  corporatestatus,Proposermustattachacertifiedcopyofanydocumentsamendingits   previoussubmissions.4 $4 $ ! '4(#X!AB8  B8BA7  .0 '   a.04' $' $HowlonghastheProposerbeeninbusiness?B8BCAی4 $4 $ Ќ  <>7^   ' >7^D<b  .0 4   HaveProposer'smajorshareholders,officersorprincipalsbeeninbusinessunder   anothername?Ifso,identifynameanddatesused.(#(#K(#_44D>7^D8D<ی 4 $4 $ Ќ  >7^  0 ' >7^E<c  .04' $' $  Howmanyyearsexperienceasaprimecontractor/consultant?  `  ___________________________>7^EE<ی{ P 4 $4 $ Ќ   ' d.0 4 Howmanyyearsexperienceasasubcontractor/subconsultant? [0  __________________________K 4 $4 $ B8  B8ƑGA8  .0 '   Listbelowthenames,businessaddresses,titles,andtelephonenumbersofthefollowing + people:ifacorporation,identifythepresident,executiveofficers,andanyotherofficers  directlyresponsibleforthisProposal;ifapartnership,identifythepartnersdirectlyresponsible   forthisProposal;or,ifanotherformofbusinessentity,identifytheprincipalsdirectly  responsibleforthisProposal.B8ƑGGAی' $' $ Ќ  *' D (#'4(#* ' Name0 Address D Title  TelephoneNo. $ $ ' (#' D (#'  (#(#K(#_   (#(#K(#_   (#(#K(#_   (#(#K(#_   (#(#K(#_ B8  B8KA9  .0    IfyourfirmconsidersitselftobeanMBE,WBEorDBE,thenwithinthepastthreeyearshas [0 theProposerhadanyMBE,WBE,orDBEcertification(orapplicationforsuchcertification) K  revokedor,ifyoumadeapplicationforsuchcertificationduringsuchperiodwassamedenied?B8KKA ی;  $ $ Ќ  !  (#(#!  YES E51Z \ @@E ""  NO E51Z \ @@E " " ߀Ifansweris"YES",explain: "! % (# (#TN%C  H #C (#(#  (#(#K(#_   (#(#K(#_   (#(#K(#_   (#(#K(#_ " (#(#4P"% (#&K(#%A@?) dE' A '$' % (# (#Q% PARTIIIPROPOSER'SREPRESENTATIONS (%) D9V  D9VQCI  .0    BysubmissionofthisProposal,theundersignedandeachpersonsigningonbehalfofthe *'+ undersignedcertifies,andinthecaseofajointproposaleachpartytheretocertifies,astoits +o(, ownorganization,asrequiredbySection2878ofthePublicAuthoritiesLawoftheStateof ,_)- NewYork,underpenaltyofperjury,thattothebestofitsknowledgeandbelief:D9VQRCیz-O*. $ $    j.?+/ <>7^  XB.p x(08"(#B   >7^T<a  .0 p   thepricesinthisProposalhavebeenarrivedatindependentlywithoutcollusion, +  consultation,communication,oragreementforthepurposeofrestrictingcompetition,  astoanymatterrelatingtosuchpriceswithanyotherproposerorwithanycompetitor;>7^T U<ی p $p $ Ќ   XE14 <DL!T$XE XB.p x(08"XB   b.0 p unlessotherwiserequiredbylaw,thepriceswhichhavebeenquotedin thisProposal  havenotbeenknowinglydisclosedbytheProposeraridwillnotknowinglybe  disclosedbytheundersignedpriortoopening,directlyorindirectly,toanyother  proposerortoanycompetitorpriortotheclosingdateforproposals; p $p $   XE14 <DL!T$XE<>7^  XB.p x(08"XB   >7^Y<c  .0 p   noattempthasbeenorwillbemadebytheProposertoinduceanyotherperson,  p  partnershiporcorporationtosubmitornottosubmitaproposalforthepurposeof  `  restrictingcompetition;>7^YlZ<ی{ P p $p $ Ќ   XE14 <DL!T$XE0  AProposalshallnotbeconsideredforawardnorshallanyawardbemadewherea,b,andc, [0  above,havenotbeencompliedwithprovided,however,thatifinanycasetheProposercannot K  maketheforegoingcertification,theProposershallsostateandshallfurnishwiththeProposala ; signedandnotarizedstatement whichsetsforthindetailthereasonstherefor.Wherea,b,andc, + above,havenotbeencompliedwith,theProposalshallnotbeconsideredforawardnorshall  anyawardbemadeunlesstheVicePresident,DivisionofMaterieloftheAuthority,orhis/her   designee,determinesthatsuchdisclosurewasnotmadeforthepurposeofrestricting  competition. $ $ 0  ThefactthataProposer(i)haspublishedpricelists,rates,ortariffscoveringitemsbeing  procured;(ii)hasinformedprospectivecustomersofproposedorpendingpublicationofnewor  revisedpricelistsforsuchitems;or(iii)hassoldthesameitemstoothercustomersatthesame  pricesbeingproposed,doesnotconstitute,withoutmore,adisclosurewithinthemeaningofa, p b,andcabove` $ $ 2.  Statementofnoconflictofinterest k@  XB.p x(08"XB   a.0 p Noappointedorelectedofficial,memberorotherofficeroremployeeoftheCityor K  StateofNewYork,oroftheMetropolitanTransportationAuthority("MTA"),or ;  MTA'saffiliatesaridsubsidiarieswhichconsistoftheNewYorkCityTransit +!  Authority,Manhattan&BronxSurfaceTransitOperatingAuthority,StatenIsland "! RapidTransitOperatingAuthority,MetroNorthCommuterRailroad,LongIslandRail  #" Road,TriboroughBridgeandTunnelAuthority,MetropolitanSuburbanBusAuthority, # # andMetropolitanTransportationAuthorityCardCompany:i)isinteresteddirectlyor $!$ indirectly,inanymannerwhatsoeverinorintheperformanceoftheContractorinthe %"% supplies,workorbusinesstowhichitrelatesor inanyportionoftheprofitsthereof;or &#& ii)hasbeenorwillbeofferedorgivenanytangibleconsiderationinconnectionwith '$' thisProposal/Contract.(%(p $p $   XE14 <DL!T$XE<>7^  XB.p x(08"XB   >7^g<b  .0 p   ProposercovenantsthatneitherProposernor,tothebestoftheProposer'sknowledge *`'* afterdiligentinquiry,anydirector,officer,owneroremployeeoftheProposerhasany {+P(+ interestnorshalltheyacquireanyinterest,directlyorindirectly,whichwouldconflict k,@), inanymannerordegreewiththefaithfulperformanceoftheContracthereunder.>7^g h<ی[-0*-p $p $ Ќ   XE14 <DL!T$XE>7^  XB.p x(08"XB   >7^j<c  .0 p   IntheeventProposerhasnopriorknowledgeofaconflictofinterestassetforthin"a" ;/,/ and"b"aboveandhereafteracquiresinformationwhichindicatesthattheremaybean +0-0 actualorapparentviolationofanyoftheabove,Proposershallpromptlybringsuch + informationtotheattentionoftheAuthority'sChiefProcurementOfficer,Proposer  shallthereaftercooperatewiththeAuthority'sreviewandinvestigationofsuch   information,andcomplywithanyinstructionitreceivesfromtheChiefProcurement  Officerinregardtoremedyingthesituation.>7^j)k<یp $p $ Ќ   XE14 <DL!T$XEA B8  B8nA3  .0    ThefollowingstatementsapplytoanyproposalorcontractbetweenProposerandtheCityor  StateofNewYork,anyotherstate,anypublicauthorityorotherpublicentity,theUnitedStates   government,theMetropolitanTransportationAuthority("MTA"),andMTA'saffiliatesand   subsidiarieswhicharetheNewYorkCityTransitAuthority,Manhattan&BronxSurface  p  TransitOperatingAuthority,StatenIslandRapidTransitOperatingAuthority,MetroNorth  `  CommuterRailroad,LongIslandRailRoad,TriboroughBridgeandTunnelAuthority, { P  MetropolitanSuburbanBusAuthority,andMetropolitanTransportationAuthorityCard k@  Company.B8noAی[0  $ $ Ќ  XB.p x(08"XB   a.0 p Statementsb,c,d.e,fandgbelowalsoapplytoi)Proposer'sparent,subsidiariesand ; affiliates(ifany),ii)anyjointventure(includingitsindividualmembersandanyother + formofpartnership(includingitsindividualmembers)whichincludesProposeror  Proposer'sparent,subsidiaries,oraffiliates;iii)Proposer'sdirectors,officers,principals,   andmanagerialemployeesandanypersonorentitywitha10%ormoreinterestin  Proposer;iv)anylegalentitycontrolled,or10%ormoreofwhichisowned,by  Proposer,orbyanydirector,officer,principalormanagerialemployeeofProposer,or  byanypersonorentitywitha10%ormoreinterestinProposer;orv)anyparent,  subsidiaryoraffiliateofanylegalentitycontrolled,or10%ormoreofwhichisowned,  byProposer,orbyanydirector,officer,principalormanagerialemployeeofProposer,  oranypersonorentitywitha10%ormoreinterestinProposer.pp $p $  ` <>7^    >7^7x<b  .0 p   HastheProposerbeendeclarednotresponsible.(Check"YES"or " NO ", as {P appropriate.)>7^7x^x<یk@p $p $ Ќ   [0 0   p YES E51Z \ @@E P @   x NO  E51Z \ @@EP@ K  $ $ C  H; C 0  c.0p $ $HastheProposerbeendebarred,suspended,proposedfordebarment,declared +!  ineligible,voluntarilyexcluded,orotherwisedisqualifiedfrombidding,proposing,or "! contracting.(Check"YES"or"NO",asappropriate.) #"p $p $  # #   0 p YES E51Z \ @@E $ $  x NO E51Z \ @@E$$$!$p $p $  C  H%"C 0  d.0p $ $HastheProposerbeenadefaulter,asprincipal,suretyorotherwise.(Check"YES"or &#& "NO",asappropriate.)'$'p $p $  (%(   0 p YES E51Z \ @@E ) )  x NO E51Z \ @@E)) )p&)p $p $ C  H*`'C 0  e.0p $ $Hasthegovernmentorotherpublicentityrequestedorrequiredenforcementofanyof {+P(+ itsrightsunderasuretyagreementonthebasisofaProposerdefaultorinlieuof k,@), declaringProposerindefault.(Check"YES"or"NO",asappropriate.)[-0*-p $p $  K. +.  0   p YES E51Z \ @@E @/ 0/  x NO E51Z \ @@E@/0/ ;/,/ $ $ C  H+0- C +0-0  0  f.0p $ $IstheProposerinarrearsuponacontractordebt.(Check"YES"or"NO",as + appropriatep $p $     0   p YES E51Z \ @@E    x NO E51Z \ @@E $ $ C  H C<>7^  0  >7^D<g  .0p $ $  ArethereanyproceedingpendingrelatingtoProposer'sresponsibility,debarment,  suspension,voluntarilyexclusionorqualificationtoreceiveapubliccontract.(Check  "YES"or"NO".asappropriate.)>7^Dk<ی p $p $ Ќ      0   p YES E51Z \ @@E    x NO E51Z \ @@E    p  $ $ C  H ` C 0  h.0p $ $Listthenameandbusinessaddressofeachpersonorlegalentitywhichhasa10%or { P  moreownershiporcontrolinterestinProposer(attachadditionalpagesasneeded).k@ p $p $ ! (#X!  )_(#(#K(#_* [0    )_(#(#K(#_* K    )_(#(#K(#_* ;   )_(#(#K(#_* +   EG9  $ (#<$  G9zEi  .0    Explainany"YES"answerstob,c,d,e,fandginthespaceprovidedbelow(attach   additionalpagesasneeded).G9zŌEی $ $ Ќ      (#(#K(#_    (#(#K(#_    (#(#K(#_    (#(#K(#_( <(#($ (#<$   p A@?) dE A `    k  PARTIV󀄀QUESTIONSWHICHMUSTBEANSWERED"YES"OR"NO" o  (Intheeventofa"YES",theAuthorityreservestherighttoinquirefurtherwithrespectthereto.) _  gX zO   0  Tothebestofyourknowledgeafterdiligentinquiry,inconnectionwiththebusinessof j? proposeroranyotherfirmwhichisrelatedtoProposerbyanydegreeofcommonownership, Z /  control,orotherwise,doanyofthefollowingstatementsapplyto:i)Proposer;ii)Proposer's J!! parent;iii)anyProposersubsidiaryoraffiliate;iv)anyjointventure(includingitsindividual :"" members)oranyotherpartnership(includingitsindividualmembers)whichincludes *## ProposerorProposer'sparent,subsidiaries,oraffiliates,v)anylegalentity,orparent, $ $ subsidiaryoraffiliateofanylegalentity,controlled.or10%ormoreofwhichisowned,by  %!% Proposer,orbyanydirector,officer,principalormanagerialemployeeofProposer,orby %"& anypersonorentitywitha10%ormoreinterestinProposer.orvi)anypersonwhoisa &#' director,officer,principal,or,managerialemployee,orpersonorentitywitha10%ormore '$( interestinanyoftheaforesaid:(%)(#(# ސ )&* 1  Hasbeenconvictedbyapleaorverdictofguiltilyof,orpleadednolocontendereto,a *'+ misdemeanororfelonyinanyfederal,stateorlocalcourt.(Check"YES"or"NO",asappropriate.) +o(, #&B)%XXHJ#XHX%&B)HXHXXXH ,_)- $ ' 7#(#$  YES E51Z \ @@E-o- NO#XHXXHXH2##&B)%XXH# E51Z \ @@E - o-  z-O*. C  Hj.?+ C 2  Havependinganystateorfederalgrandjuryorcourtanindictmentorinformationforthecommissionof F/,0 acrimewhichhasriotbeenfavorably,'terminated.(Check"YES"or"NO",asappropriate.) "0,1  XHX%&B)IXHXXXH +   YES E51Z \ @@E  NO  E51Z \ @@E    C  H C#XHXXIXHk##&B)%XXHL# 3.  Isthesubjectofanypendinginvestigationbyanygrandjury,commission,committeeorotherentityor  agencyorauthorityofanystateorthefederalgovernmentinconnectionwiththecommissionofacrime.  (Check"YES"or"No",asappropriate.) ` XHX%&B)HXHXXXH g<   YES E51Z \ @@EH 8  NO#XHXXHXHɝ##&B)%XXH瞧# E51Z \ @@E H  8   C  C  H3 C 4.  Iscurrentlydisqualifiedfromsellingorsubmittingbids/proposalstoorreceivingawardsfromorentering    intoanycontractswithanyfederal,stateorlocalgovernmentalentity,anypublicauthorityoranypublic    entity(Check"YES"or"NO",asappropriate.)     x     XHX%&B)HXHXXXHYES E51Z \ @@Et NO#XHXXHXHY##&B)%XXH:# E51Z \ @@E  t  T  C  HoD C 5.  Withinthepastfiveyears,.hasrefusedtotestifyortoansweranyquestionconcerningabidorcontract K  withanyfederal,state,orlocalgovernmentalentity,anypublicauthorityorotherpublicentitywhencalled '  beforeagrandjuryorothercommittee,agencyorforumwhichisempoweredtocompeltheattendance  ofwitnessesandexaminethemunderoath,uponbeingadvisedthatneithertheperson'sstatementnorany  informationorevidencederivedfromsuchstatementwillbeusedagainstthatpersoninanysubsequent  criminalproceeding.(Check"YES"or"NO"asappropriate.) l  sH    XHX%&B)HXHXXXHYES E51Z \ @@ETD  NO#XHXXHXHG##&B)%XXH(# E51Z \ @@E T D!  O$ C  H?C 6.  Iscurrentlydisqualifiedfromsellingorsubmittingabidto,orreceivinganawardfrom,orenteringinto  anycontractwithanypublicentityorpublicauthoritywithintheStateofNewYorkbecause,withinthe  pastfiveyears,suchentityorpersonrefusedtotestifyortoansweranyrelevantquestionconcerninga  transactionorcontractwiththeStateofNewYork,anypoliticalsubdivisionoftheStateofNewYork,  orapublicauthorityorapublicdepartment,agencyorofficialoftheStateofNewYorkorofapolitical ` subdivisionoftheStateofNewYork,whencalledbeforeagrandjuryorotherstateorlocaldepartment, g< commissionoragencywhichisempoweredtocompeltheattendanceofwitnessesandexaminethem C underoath.uponbeingadvisedthatneitherthatperson'sstatementnoranyinformationorevidence  derivedfromsuchstatementwillbeusedagainstthatpersoninanysubsequentcriminalproceeding,   (Check"YES"or"NO",asappropriate.) !   "    XHX%&B)HXHXXXHYES E51Z \ @@E!!" NO#XHXXHXH##&B)%XXH# E51Z \ @@E ! !#  !d# C  H"TC 7.  HaswithinathreeyearperiodprecedingthisProposalbeenconvictedoforhadaciviljudgmentrendered [#0 % againstthemforcommissionoffraudoracriminaloffenseinconnectionwithobtaining,attemptingto 7$ !& obtain.orperformingapublic(Federal,Stateorlocal)transactionorcontractunderapublictransaction; %!' violationofFederalorStateantitruststatutesorcommissionofembezzlement,theft,forgery,bribery, %"( falsificationordestructionofrecords,makingfalsestatements,orreceivingstolenproperty.(Check &#) "YES"or"NO",asappropriate.) '|$*  (X%+    XHX%&B)HXHXXXHYES E51Z \ @@Ed)T)$ NO#XHXXHXH۱##&B)%XXHＱ# E51Z \ @@E d) T)%  _)4&, C  HO*$'C 8.  Explainany"YES"answersto1,2,3,4,5,6or7,inthespaceprovidedbelow(attachadditionalpagesas ++(. needed). ,(/ ! '7#' 7#! '7#'7#  F#F#KF#_   F#F#KF#_   F#F#KF#_  w/L,3 " '7#'7#"A@?) d ER0 A S0(-4 Ї PARTVTECHNICAL +       6F#'7#1.0  Listthename,titleandbusinessaddressofeachdirectorandprincipalofficerofProposer. $ $   F#F#KF#_   F#F#KF#_   F#F#KF#_   F#F#KF#_      g 2.0  Numberofemployees:_______________including____________employeesintheGreaterNewYork    MetropolitanArea.   $ $   t  AB8  B8aA3  .0    DoestheProposerhaveanyoutstandingbidsorproposalsforcontracts(i.e.,bidsorproposalspendingwhere { P  nocontracthasyetbeenawarded)withtheStateorCityofNewYork,oranyotherpublicauthorityofthe W,  StateofNewYork,ortheMetropolitanTransportationAuthority("MTA"),andMTA'saffiliatesand 3  subsidiarieswhicharetheNewYorkCityTransitAuthority,Manhattan&BronxSurfaceTransitOperating   Authority,StatenIslandRapidTransitOperatingAuthority,MetroNorthCommuterRailroad,LongIsland   RailRoad,TriboroughBridgeandTunnelAuthority,MetropolitanSuburbanBusAuthority,and  MetropolitanTransportationAuthorityCardCompany?Ifnone,state"None".Ifyes,pleaselistthemand x providethenameoftherequestingagency,thecontractnumber,abriefdescriptionoftheworkeffortand T thestatusofthebidorproposal.Indicateifthebid/proposalwassubmittedbytheBidderasprimecontractor [0 orjointventure.B8a|Aی7  $ $ Ќ    ""J"_   ""J"_   ""J"_   ""J"_   ""J"_   ""J"_   B8  B8޾A4  .0    HastheProposerbeenawardedanycontractswithinthelastthreeyearsbytheStateorCityofNewYork,  oranyotherpublicauthorityoftheStateofNewYork,ortheMetropolitanTransportationAuthority  ("MTA"),andMTA'saffiliatesandsubsidiarieswhicharetheNewYorkCityTransitAuthority,Manhattan  &BronxSurfaceTransitOperatingAuthority,StatenIslandRapidTransitOperatingAuthority,MetroNorth   CommuterRailroad,LongIslandRailRoad,TriboroughBridgeandTunnelAuthority,Metropolitan \! SuburbanBusAuthority,andMetropolitanTransportationAuthorityCardCompany?Ifnone,state"None". c 8" Ifyes,describethosecontractsbeginningwiththemostrecent.Statethenameofthecontractingentity;give ?!# abriefdescriptionofthecontractandthecontractnumber;statethecontractperiod,thestatusofthecontract, "$ andthename,address,andtelephonenumberofacontactpersonattheagency.Indicateifawardwasmade "% toProposerasprimecontractororjointventure.Proposerneednotprovidemorethansixsuchdescriptions.B8޾Aی# & $ $ Ќ    ""J"_   ""J"_   ""J"_   ""J"_   ""J"_  (%, 5.  DoestheProposerhaveanycurrentprivatesectorprojects?Ifnone,state"None".Ifyes,providenameand )&- addressofowner,abriefdescriptionofwork,statusofcontractsandname,addressandtelephonenumber *'. ofcontactpersonastoeach,beginningwiththemostrecent.IndicateifProposerisactingasprime +d(/ contractororjointventure.Proposersneednotprovidemorethansixsuchdescriptions. k,@)0   ""J"_   ""J"_   ""J"_   ""J"_  /,4   ""J"_   AB8  B8ƈA6  .0    Foreachofthefollowingcontracts,provideabriefdescriptionoftheworkperformed,thecontractnumber,  thedollaramountatawardandatcompletion,datecompleted,andthenameandtelephonenumberofthe  owner'srepresentative.B8ƈAیp $ $ Ќ   wL <>7^  $S X6F#$0  >7^<a  .0S $ $  Eachcontractcompletedduringthelastthreeyearsor,iflessthanthreecontractshavebeencompleted S( duringthelastthreeyears,listthelastthreecontractscompleted.>7^<ی/ S $S $ Ќ  $ S"S X$ S ""I"_SS S ""I"_SS S ""I"_SS S ""I"_SS S ""I"_SS W,  >7^  X $'S/ XS"$  >7^B<b  .0 S   Eachcontractcompletedduringthelastthreeyearsor,iflessthanthreecontractshavebeencompleted 3  duringthelastthreeyears,listthelastthreecontractscompleted,forwhichliquidateddamagesor   penaltyprovisionswereassessedagainstyouforfailuretocompletetheworkontimeorforanyother   reason.>7^B<یS $S $ Ќ  X$ S"'S/ X$ "S"  ""I"_  ""I"_  ""I"_  ""I"_  ""I"_" S"""XHX%&B)   "S"B8  B8EA7  .0    Listeachcontractwhich,duringthelastthreeyears,theperson/entitycontractingwithyou:i)  terminatedfordefault;ii)suedtocompelperformance;iii)suedtorecoverdamages,including,  withoutlimitation,uponallegedbreachofcontract,misfeasance,errororomissionorotheralleged  failureonyourparttoperformasrequiredbyyourcontract;oriv)calleduponasuretytoperform p thework.B8EnAی` $ $ Ќ    ""I"_   ""I"_   ""I"_   ""I"_   ""I"_   8.0  Describewhetheranypresentoranticipatedcommitmentsand/orcontractualobligationsmighthave "# aninfluenceonthecapabilitiesoftheProposertoperformtheworkcalledforbythisContract.  #$ Anyapparentconflictsasbetweentherequirements/commitmentsforthisContractandthematters # % listedinitems3,4,5or6,above,withrespecttotheuseofProposer'sresources,suchas $!& managementortechnicalexpertiseorfinancing,shouldbeexplained.Ifnone,state"None".%"' $ $   ""I"_   ""I"_   ""I"_   ""I"_   ""I"_ 9.  DescribeanylitigationinwhichtheProposerisinvolved,which: k,@). <>7^  X?+ p x(08""?>7^<a  .0    hasormayhaveanimpactontheProposer'sabilitytoperformanyworkcalledforbythis K. +0 solicitation;or>7^<ی;/,1 $ $ Ќ  XE14 <DL!T$XE +0-2  X?+ p x(08"X?b.0  thedemandorpotentialexposureisformorethan$250,000,exclusiveofpersonalinjury + litigationwheretheliabilityiscoveredbyinsurance. $ $  XE14 <DL!T$XE$"c$X$  Ifnone,state"None."    ""I"_   ""I"_   ""I"_   ""I"_ 0  ""I"_  @"   $ $   ""I"_   A B8  B8ƍA10  .0    Duringthepastthreeyears,hastheProposer'sfirmeverbeenapartytoabankruptcyor { P  reorganizationproceeding?B8ƍA یk@  $ $ Ќ  0` N "c$"c$00  YES E51Z \ @@EP@& `  N NO E51Z \ @@E P @'߀Ifansweris"YES"explainbelow.K  $ $ 4"c$` N "c$4C  H;C  -"c$"c$-11.  a.0  Ifanyprofessionalorotherlicenses,permits,orcertificationsarerequiredtoperformthe + work/servicescalledforbythissolicitation,listthelicense,permit,orcertificationthatthe  ProposerorProposer'semployeesoragentspossess.Ifnone,state"None".  $ $ N14 <DL!T$"c$N   C LicenseorPermit K      S      [ Issuing     C orCertification K     NameofHolder   [ StateorEntity   "X0  ""I"_ @"   $ $   ""I"_  ""I"_  ""I"_  ""I"_>7^  XB.p x(08""B  ' >7^7<b  .0    HaveanyoftheProposer'sofficers,partners,owners,managersoremployeeshadany k@ projectrelatedlicenses,permitsorcertificationsrevokedorsuspendedinthepastthree [0 years.>7^7<یK  $ $ Ќ   XE14 <DL!T$XE   C YES E51Z \ @@E 0! !(  K NO E51Z \ @@E0! !)    Ifansweris"YES",explaindetailsbelow. +!  C  H"C0    $ $ A  B8  B8ƮA12  .0    DoestheProposer'sfirmshareofficespace,stafforequipment(includingtelephoneexchanges)  #" withanyotherbusinessororganization?B8ƮA ی# # $ $ Ќ  XB.p x(08"XB  ' YES E51Z \ @@E%%* NO E51Z \ @@E) %) %+ / Ifansweris"YES",listfirmname,addressandnatureofsharedfacilities. %"%  '"X  XC  H&#C ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_'' 13.0 ' HasProposer'ssafetypractices/proceduresbeenevaluatedorratedaslessthensatisfactorybythe k,@), CityorStateofNewYork,anyotherstate,anypublicauthorityorotherpublicentity,theUnited [-0*- Statesgovernment,theMetropolitanTransportationAuthority("MTA"),andMTA'saffiliatesand K. +. subsidiarieswhicharetheNewYorkCityTransitAuthority,Manhattan&BronxSurfaceTransit ;/,/ OperatingAuthority,StatenIslandRapidTransitOperatingAuthority,MetroNorthCommuter +0-0 Railroad,LongIslandRailRoad,TriboroughBridgeandTunnelAuthority,Metropolitan + SuburbanBusAuthority,andMetropolitanTransportationAuthorityCardCompanywithinthe  pastfiveyears? ' $' $  XB.p x(08"'"B  ' YES E51Z \ @@E,  / NO E51Z \ @@E-    Ifansweris"YES",explaindetailsbelow.   ''"X ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''   XC  H ` C! ': ''"!14. ' Isyourfirm'sWorkersCompensationExperienceRating1.2orgreater? { P   XE.p x(08"': E  ' YES E51Z \ @@E`P.  / NO E51Z \ @@E`P/    Ifansweris"YES",explaindetailsbelow. [0    XC  HK C '"X ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_'' A B8  B8A15  .0 '   DoesProposerhaveeitherahistoryofclaimslossoranysubstantialindividualclaimlosswithin  thepastfiveyearsduetogeneralliabilityorworkerscompensationclaims?B8Aی' $' $ Ќ  XB.p x(08"'"B  ' YES E51Z \ @@E0  / NO E51Z \ @@E1    Ifansweris"YES",explaindetailsbelow.    XC  HC '"X ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_'' #&B)%XXH#XHX%&B)160 ' Listthenames,titlesandattachresumeswhichindicatetherecordofskillandexperienceofyour K  proposedprojectmanagementteam.(SeeSpecificationsortheScopeofWorkforthefunctions ;  oftheprojectmanagementteam,asapplicable,andotherrequirementsinregardtoproject +!  management.)"!' $' $  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_'' #&B)%XXH#XHX%&B)AB8  B8ƒA17  .0 '   Whichoftheindividualsnamedinitem16,above,willbeutilizedexclusivelyonthisContracton (%( afulltimebasis?(TheSpecificationortheScopeofWorkmayindicaterequirementsforcertain )p&) dedicatedstaff.)B8ƒAی*`'*' $' $ Ќ   ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  +0-0 #&B)%XXHW#XHX%&B)180 ' Whichoftheindividualsnamedinitem16,above,arenotpresentlyofficers,partners.ownersor + employeesofthefirm?' $' $  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_'' #&B)%XXHT#XHX%&B)190 ' AttachanoutlineofyourproposedQualityControlprogram(seeappropriatesectionofthe   SpecificationsortheScopeofWork)forthisContract.WheretheSpecificationsortheScopeof  p  Worksetoutrequiredelementsfortheprogram,suchoutlinemustcovereachelement. ` ' $' $  ' #&B)%XXH#XHX%&B)A@?) ddEZ A [0     PARTIVADDITIONALQUESTIONS  j?  S1. ' ListallProposer'semployees: J <>7^  X?+ p x(08"'"?>7^<a  .0    whoarecurrentlyemployeesoftheMetropolitanTransportationAuthority("MTA"),or * anyMTAsubsidiaryoraffiliate(NewYorkCityTransitAuthority,Manhattan&Bronx  SurfaceTransitOperatingAuthority,StatenIslandRapidTransitOperatingAuthority,   MetroNorthCommuterRailroad,LongIslandRailRoad,TriboroughBridgeandTunnel  Authority,MetropolitanSuburbanBusAuthority,andMetropolitanTransportation  AuthorityCardCompany).>7^o<ی $ $ Ќ   "X X  ""I"_  ""I"_  ""I"_  ""I"_  ""I"_>7^  ! '""! ' >7^i <b  .0    whowithinthepasttwoyearshavebeenMTAorMTAsubsidiaryoraffiliateemployees j? whowereinvolvedonbehalfofProposerwiththepreparationofthisProposalorwould Z /  beinvolvedintheperformanceoftheContractifitisawardedtoProposer.>7^i  <یJ!! $ $ Ќ   ' ! "'"!  ""I"_  ""I"_  ""I"_  ""I"_  ""I"_#&B)%XXH#XHX%&B)ԈE14 <DL!T$"E  2.  DoesProposerhaveasubsidiaryoraffiliate? '$(   YES E51Z \ @@E))2  NO E51Z \ @@EE)E)3 K   Ifansweris"YES",listfirmname,addressandaffiliation )&*  '"X ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_'' #&B)%XXH#XHX%&B) Z//,0 C  H+C3. ' IsProposerasubsidiaryofanotherentity? + ! ' "'"! ' YES E51Z \ @@E4 NO E51Z \ @@E  5߀Ifansweris"YES",listfirmname,addressandaffiliation   % '"' "%C  HC ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' #&B)%XXH#XHX%&B)AB8  B8A4  .0 '   DoesProposer,anydirector,officer,principalormanagerialemployeeofProposer,oranyother  p  personorentitywitha10%ormoreinterestinProposerhaveaninterestof10%ormoreinany  `  otherfirmorlegalentity?B86Aی{ P ' $' $ Ќ  ! ' "'"! ' YES E51Z \ @@E`P6 NO E51Z \ @@E ` P7߀Ifansweris"YES",listindividualsnameandfirmorentity [0  % '"' "%C  HK C ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' #&B)%XXH#XHX%&B)5.0 ' Iftheanswerto2,3or4is"YES",wouldProposer'sanswerspertainingtoPartsIIIandIVbethe  sameforeachsuchparent,subsidiary,affiliate,firmorlegalentity?' $' $ ! ' "'"! ' YES E51Z \ @@E8 NO E51Z \ @@E  9߀Ifansweris"NO",explainbelow  % '"' "%C  HC ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' ""I"_''  ' #&B)%XXH#XHX%&B)A@?) dE: A ;     PARTVIIFINANCIAL  J!! @ AB8  B8ƨ A1  .0 '   Providecertifiedfinancialstatementsforthelastthreefiscalyears.Ifcertifiedfinancialstatements *## arenotavailable,providefinancialstatementssworntobythefirm'sChiefFinancialOfficer.B8ƨ  Aی$ $' $' $ Ќ  2.0 ' TheProposermaysubmititsprior3years'financialstatementsinlieuofcompletingSection1 %"& (BalanceSheet),Section2(ComparativeStatementofIncome&RetainedEarnings),andSection &#' 3(ComparativeStatementsofCashFlows).However,Section1,SchedulesA,B,C,D,EandF '$( andSections4,6and7mustbecompleted.IftheProposerisrequiredtosubmitaperformance (%) bond,Section5mustalsobecompleted.)&*' $' $   +o(,   SECTION1  + COMPARATIVEBALANCESHEET   asof򁁁  |$*7G"'"*  ($000) 7 19___  19___  19___  Q14 <DL!T$7XQ$7G"X$ 7 $ 2 $ - $   E+ p x(08"7XEI. ' CURRENTASSETS:  p   *T@8"X*6'7#!T@X6 ' Cash___________________________ 7 _________ # _________  __________ { P   ' MarketableSecurities______________ 7 _________ # _________  __________ k@   ' NotesReceivable(ScheduleA)_______ 7 _________ # _________  __________ [0   ' AccountsReceivable(ScheduleB)____ 7 _________ # _________  __________ K   ' BidDeposits(ScheduleC)__________ 7 _________ # _________  __________ ;  ' Inventories______________________ 7 _________ # _________  __________ +  ' PrepaidExpenses_________________ 7 _________ # _________  __________  :T@X'7#X':9@{ !8"T@X9<'7c#!@{ !,< ' OtherCurrentAssets:    ' ________________________________ 7 __________ # _________  __________   ' ________________________________ 7 __________ # _________  __________   ' ________________________________ 7 __________ # _________  __________   ' ________________________________ 7 __________ # _________  __________   ' ________________________________ 7 __________ # _________  __________  @@{ !,'7c#XT+@<@{ !8"@{ !,<9T@8"@{ !,96'7#!T@X6 ' TOTALCURRENTASSETS 7 $_________ # $________  $_________ p :T@X'7#X/:9@{ !8"T@X9 6@ !8"@{ !,60'72G"@ !,0II. ' OTHERASSETS: k@  ' InvestmentinAffiliates____________ 7 $_________ 2 $_________  $_________ K   ' OtherNonCurrentAssets: ;   ' ________________________________ 7 __________ 2 __________  __________ "!  ' ________________________________ 7 __________ 2 __________  __________  #"  ' ________________________________ 7 __________ 2 __________  __________ # #  '  7  ' TOTALOTHERASSETS 7 $_________ 2 $_________  $_________ %"% 4@ !,'72ek040@ !8"@ !,0III. ' PROPERTY,PLANT&EQUIPMENT: '$' 3T@8"@ !,33'72G"T@X3 ' NETPROPERTY,PLANT&EQUIPMENT )p&)  ' (NetofDepreciation) 7 $_________ 2 $_________  $_________ *`'*  ' TOTALASSETS 7 $ _________  2 $ _________   $ _________  k,@), 7T@X'72e47Q14 <DL!T$T@XQ  +0-0 LIABILITIES    *72G"X*  ($000) 7 19___ 2 19___  19___  Q14 <DL!T$72XQ'72G"X' 7 $ 2 $  $  H+ p x(08"72XHI. ' CURRENTLIABILITIES  *T@8"X*3'72G"T@X3 ' NotesPayable(ScheduleD)________ 7 __________ 2 _________  __________    ' AccountsPayable(ScheduleE)_____ 7 __________ 2 _________  __________  p   ' LoansPayable(ScheduleF)________ 7 __________ 2 _________  __________  `   ' TaxesPayable___________________ 7 __________ 2 _________  __________ { P   ' CurrentPortionofLongTermDebt__ 7 __________ 2 _________  __________ k@   ' AccruedLiabilities_______________ 7 __________ 2 _________  __________ [0   ' OtherCurrentLiabilities: K   ' ________________________________ 7 __________ 2 _________  __________ ;  ' ________________________________ 7 __________ 2 _________  __________ +  ' ________________________________ 7 __________ 2 _________  __________   ' ________________________________ 7 __________ 2 _________  __________    ' ________________________________ 7 __________ 2 _________  __________  7T@X'72e873{ !8"T@X33'72G"{ !,3 ' TOTALCURRENTLIABILITIES 7 $_________ 2 $________  $_________  3{ !8"'72X3*  !8"{ !,*II. ' NONCURRENTLIABILITIES  -'}-G" !,- ' LongTermDebt__________________  __________ } _________ - __________ p 6T@ !8"'}-X6 ' Other: ` -  !8"T@ !,--'}-G" !,-Ӏ ' ________________________________  __________ } _________ - __________ {P  ' ________________________________  __________ } _________ - __________ k@  ' ________________________________  __________ } _________ - __________ [0  ' TOTALNONCURRENTLIABILITIES  $_________ } $________ - $_________ ;   ' TOTALLIABILITIES  $ _________  } $ ________  - $ _________  "! 1  !,'}-XA1$  !8" !,$III. ' EQUITY # #  ' CapitalStockPaidUp: %"% -T@8" !,-0'G"T@X0 ' Common______________________  $_________ } $_________ x $_________ '$'  ' Preferred______________________  $_________ } $_________ x $_________ (%( Ѐ )p&)  ' Surplus(networth)________________  $_________ } $_________ x $_________ *`'*  ' TOTALEQUITY  $ _________  } $ _________  x $ _________ k,@),   ' TOTALLIABILITIESANDEQUITY  $ _________  } $ _____ _ ___  x $ ___ _ _____  K. +.  4T@X'G"E43@ !8"T@X3  +0-0 N14 <DL!T$@ !,N  +   DETAILSRELATIVETOASSETS  +  SCHEDULEA    mI* ddd Xdd Xdd X $ $,xjj+  :' 8:'X<XX' 6    > 0 < (a)duewithin90days____________$______________#<"<"  0 6 NotesReceivable  >  < (b)dueafter90days____________$______________6"6"  6    > 0 < (c)pastdue_____________________$______________ <"<" 7-+  8  7*_ ddxjjx $ $_, jZ,jZ,jZ,jZ,jj+  6'   860 6 ReceivableFrom:  66 0 6 Name E6+  66 EPurpose ;,!  " ;Dateof    Maturity ;,!  " ;How   Secured ?,! " ?Amount N?' " 8  8N ;,!3   ; ;,!3   ; ;,!3   ; ?,!3   ?$ N?'3   8  8N ;,![0  ; ;,![0  ; ;,![0  ; ?,![0  ? N?'[0  8  8N ;,!X  ; ;,!X  ; ;,!X  ; ?,!X  ? N?'X  8  8N ;,!  ; ;,! ! ; ;,! " ; ?,! # ? N?' $ 8  8N ;,!% ; ;,!& ; ;,!' ; ?,!( ? N?') 8  8N ;,!* ; ;,!+ ; ;,!, ; ?,!- ? N?'. 8  8N ;,!#/ ; ;,!#0 ; ;,!#1 ; ?,!#2 ? N?'#3 8  8N ;,!K 4 ; ;,!K 5 ; ;,!K 6 ; ?,!K 7 ?7-+K 8 8   7* d d jZ jZjZjZjj $ $,jZ,jj+  8';8; 88 6    >  <    F     TOTAL ?,!sH9 ?$7-+sH: 8  7   SCHEDULEB  S(< [*r ddjZjj $ $r,xjj+  :'3>3 8:  6  AgingofAccountsReceivable F   PASTDUE  [0@ 7-+K A 8  7*_ ddxjjx $ $_,jZ,jZ,jZ,jZ,jZ,jj+  6';A; 86Current ;,!sHB" ;1to sHC 30days ;,!c8D" ;31to sHE 60days ;,!c8F" ;61to sHG 90days ;,!c8H" ;Over sHI 90Days ?,!c8J" ?Total N?'sHK" 8  8N0 6 Trade$ E6+ `L6^ 6^  E$ ;,! `M ;$ ;,! `N ;$ ;,! `O ;$ ?,! `P ?$ N?' `Q 8  8N0 6 Other$ E6+!R6^ 6^  E$ ;,!!S ;$ ;,!!T ;$ ;,!!U ;$ ?,!!V ?$ P?'!W 8  8P 0 6 Total$ G6+"X6^ 6^  G $ =,!"Y =$ =,!"Z =$ =,!"[ =$ ?,!"\ ?$7-+"] 8   7  SCHEDULEC %"_  e* ddjZjZjZjZjZjj $ $, jZ, jZ,jj+  6''p$a'p$ 86 BidDeposit  '$b HolderofDeposit:Name ;,!(%c" ;Description ?,!'$d" ?Amount N?''$e" 8  8N ;,!)&f ; ?,!)&g ?$ N?')&h 8  8N ;,!+'i ; ?,!+'j ? N?'+'k 8  8N ;,!;,)l ; ?,!;,)m ? N?';,)n 8  8N ;,!c-8*o ; ?,!c-8*p ? N?'c-8*q 8  8N ;,!.`+r ; ?,!.`+s ? 7-+.`+t 8   7* dd jZ jZ jj $ $,pjZ,jj+  8'++ 88  6    >  <    F   TOTAL ?,!c8 ?$7-+c8 8  7   DETAILSRELATIVETOLIABILITIES  S(  SCHEDULED  3 *n*r ddpjZpjj $ $r,` jZ,jj+  6'   86 NotesPayable  ;    ?,!+   ?(a)  NotPastDue F __________________$_______________ K   (b)  PastDue F __________________$_______________7-+;   8  7*r dd` jZ` jj $ $r,jZ,jZ,jZ,jj+  6'    86ToWhom:Name ;,!S ( " ;Purpose ;,!S ( " ;WhenDue ?,!S ( " ?Amount N?'S ( " 8  8N ;,!{ P  ; ;,!{ P  ; ?,!{ P  ?$ N?'{ P  8  8N ;,!x  ; ;,!x  ; ?,!x  ? N?'x  8  8N ;,!  ; ;,!  ; ?,!  ? N?'  8  8N ;,!  ; ;,!  ; ?,!  ?7-+  8   7* ! ddjZjZjZjj $ $,jZ,jj+  8'  88 6    >  <    F     TOTAL ?,!! ?$7-+" 8  7   SCHEDULEE  $ y*r"# ddjZjj ! $ $r,` jZ,jj+  6'& 86 AccountsPayable  (  ?,!) ?(a)  NotPastDue F __________________$_______________ * (b)  PastDue F __________________$_______________7-++ 8  7*r$% dd` jZ` jj"# $ $r,jZ,jZ,jZ,jj+  6'+ 86ToWhom:Name ;,!," ;Purpose ;,!-" ;Date . Payable ?,! /" ?Amount N?'0" 8  8N ;,!31 ; ;,!32 ; ?,!33 ?$ N?'34 8  8N ;,![05 ; ;,![06 ; ?,![07 ? N?'[08 8  8N ;,!X9 ; ;,!X: ; ?,!X; ? N?'X< 8  8N ;,!= ; ;,!> ; ?,!? ?7-+@ 8   7*&' ddjZjZjZjj$% $ $,jZ,jj+  8' p@ p 88 6    >  <    F     TOTAL ?,! A ?$7-+ B 8  7   SCHEDULEF  # D ك*r() ddjZjj&' $ $r,` jZ,jj+  6'&X#G&X# 86 LoansPayable  '$I  ?,!(p%J ?(a)  NotPastDue F __________________$_______________ &#K (b)  PastDue F __________________$_______________7-+'$L 8  7*r*+ dd` jZ` jj() $ $r,jZ,jZ,jZ,jj+  6')`&L)`& 86ToWhom:Name ;,!)&M" ;Purpose ;,!)&N" ;Date )&O Payable ?,!*'P" ?Amount N?')&Q" 8  8N ;,!+(R ; ;,!+(S ; ?,!+(T ?$ N?'+(U 8  8N ;,!-)V ; ;,!-)W ; ?,!-)X ? N?'-)Y 8  8N ;,!+.+Z ; ;,!+.+[ ; ?,!+.+\ ? N?'+.+] 8  8N ;,!S/(,^ ; ;,!S/(,_ ; ?,!S/(,` ? 7-+S/(,a 8   7*,- ddjZjZjZjj*+ $ $,jZ,jj+  8'++ 88  6    >  <    F     TOTAL ?,!c8 ?$7-+c8 8  7 SECTION2  C COMPARATIVESTATEMENTOFINCOME&RETAINEDEARNINGS # STATEMENTFORPERIODSENDED򁁁   3'}-G"X<X3 '   19___ } 19___ - 19___    Q14 <DL!T$'}-XQ*'}-G"X* ' SALES___________________________  $________ } $_________ - $_________   6'}-G"'}-X6 ' Less: h  6'}-G"'}-X6 ' COSTOFSALES: sH 6}-G"'}-X6  Labor_____________________  _________ } _________ - __________ S(   Material___________________  _________ } _________ - __________ C   Depreciation________________  _________ } _________ - __________ 3   OtherOverhead_____________  _________ } _________ - __________ #   GROSSMARGIN  $________ } $________ - $_________  :'}-X}-X:3p08"'}-X3-}-G"p8"-  Less:Selling,Generaland    AdministrativeExpenses______  _________ } _________ - __________    IncomeBeforeTaxes_________  _________ } _________ - __________    Less:IncomeTaxes__________  _________ } _________ - __________ x 1p8"}-1-p08"p8"--}-G"p8"-1p8"}-1-}-G"p8"-  NETINCOME  $________ } $________ - $_________  X    RetainedEarningsBeginning c"8"   ofPeriod_______________  $________ } $________ - $_________ S#( #   Less:CashDividendsPaid____  $________ } $________ - $_________ C$!$   Other:________________  $________ } $________ - $_________ 3%"%   NetRetainedEarningsEnd '#'   ofPeriod________________  $ _________  } $ _________  - $ _________  ($(  1p8"}-d1K14 <DL!T$p8"K   *'+   SECTION3  + COMPARATIVESTATEMENTSOFCASHFLOWS   FORTHEYEARSENDED򁁁  Increase(Decrease)inCash  5'T@8"X' c 19___ O 19___  19___   H+ p x(08"T@XH''!G"X'-'D'!,-0 ' Cashflowsfromoperatingactivities:_______0D' $' $$_________  $_________  $___________ p D $D $  ' Cashreceivedfromcustomers____________ D __________  _________  __________ { P   ' Cashpaidtosuppliers&employees_______ D __________  _________  ___________ k@   ' InterestPaid__________________________ D __________  _________  ___________ [0   ' IncomeTaxesPaid_____________________ D __________  _________  ___________ K   ' Miscellaneousreceipts(payments)________ D __________  _________  ___________ ; 1'!,'D10'DG"'!,0 ' ____________________________________ D __________  _________  ___________ +  ' ____________________________________ D __________  _________  ___________   ' ____________________________________ D __________  _________  ___________   4'!,'D9à40{ !8"'!,03T@8"{ !,36'D!G"T@X6 ' Netcashprovidedbyoperating.activities__ D $_________  $________  $__________  Cashflowsfrominvestingactivities:0 D __________  _________  ___________D $D $ :T@X'D!, :0'DT@X0 ' Proceedsfromsaleofequipment:__________ D __________  _________  ___________   ' Paymentsforpurchaseofequipment:_______ D __________  _________  ___________ p  ' _____________________________________ D __________  _________  ___________ `  ' _____________________________________ D __________  _________  ___________ {P  ' _____________________________________ D __________  _________  ___________ k@ 4T@X'D4-  !8"T@X--T@8" !,-6'DG"T@X6 ' NetCashUsedinInvestingactivities:_______ D $_________  $________  $__________ K  0 ' Cashflowsfromfinancingactivities: D __________  _________  ___________+! ' $' $  ' Netincreaseinshorttermdebt: D __________  _________  ___________  #"  ' Proceedsfromissuanceoflongtermdebt___ D __________  _________  ___________ # # :T@X'DX:-  !8"T@X--'DG" !,- ' Repaymentoflongtermdebt_____________ D __________  _________  ___________ $!$  ' PaymentofDividends___________________ D __________  _________  ___________ %"%  ' _____________________________________ D __________  _________  ___________ &#&  ' _____________________________________ D __________  _________  ___________ '$'  ' _____________________________________ D __________  _________  ___________ (%( 1  !,'DX1$  !8" !,$-'DG" !,- ' NetCashprovidedby(usedin)financing )p&)  ' activities D $_________  $________  $__________ *`'*  ' 0 ' Netincrease(decrease)incash____________ D $_________  $________  $__________k,@),' $' $ 0 ' Cashatbeginningofyear________________ D $_________  $________  $__________K. +.' $' $ 0 ' Cashatendofyear_____________________ D $_________  $________  $__________+0-0' $' $ 1  !,'DX1*p08" !,* A@?)6( dE6  A    K14 <DL!T$p8"K  SECTION4IDENTITYOFOWNERS   0  Whoaretheprincipalownersorshareholdersofthebusinessenterpriseandapproximatelywhat  percentagedoeseachown? $ $ *r./ ddjZjj,- $ $r,jZ,1jj+  6'    86Name ?,!  " ?PercentOwned N?'  " 8  8N ?,!*   ? N?'*   8  8N ?,!R '  ? N?'R '  8  8N ?,!zO  ? N?'zO  8  8N ?,!w  ? N?'w  8  8N ?,!  ? N?'  8  8N ?,! ? P?' 8  8P ?,! ?7-+ 8   7 A@?)6( d,E6  A       SECTION5PERFORMANCEBONDINFORMATION   0  Section5isonlyapplicabletosolicitationsinwhichtheProposerisrequiredtoprovidea  performancebond. $ $ 0  Namesandaddressesofbondingcompanyorcompaniesthathaveagreedtofurnishthe ! performancebondrequiredbytheContract." $ $ *r01 ddjZ1jj1./ $ $r, jZ, jZ,jZ,jj+  6'n$n 86Name ;,!%" ;Address ;,!&" ;Amount ?,!'" ?ExpirationDate N?'(" 8  8N ;,!) ; ;,!* ;$ ?,!+ ? N?', 8  8N ;,!! - ; ;,!! . ; ?,!! / ? N?'! 0 8  8N ;,!I!1 ; ;,!I!2 ; ?,!I!3 ? N?'I!4 8  8N ;,!q"F5 ; ;,!q"F6 ; ?,!q"F7 ? P?'q"F8 8  8P =,!#n 9 = =,!#n : = ?,!#n ; ?7-+#n < 8   7 A@?)6( ddE6% A %^"=   SECTION6SUBCONTRACTS  &m#? 0  WhatpartsofthisContract,ifany,doesProposerexpecttosubcontract?x(M%A $ $ *23 dd jZ jZ jZjj01 $ $,` jZ,jj+  6'X*-'CX*-' 86PortionofWork ?,!*e'D" ?NameandAddressofProposed *e'E Subcontractor,ifknown N?'+U(F" 8  n8N ?,!,})G ? SD,,})H 8 n  n8S ?,!.*I ? SD,.*J 8 n  n8S ?,!/Y,K ? UD,/Y,L 8 n  n8U ?,!c8 ?<20c8 8 n   <B.7% x(08"XB A@?)6( d E6 A ^   SECTION7CERTIFICATION m  0 F IcertifythattheattachedfinancialstatementsforthisProposalproperlyreflectthefinancialposition xM ofthecompanyfortheperiodsindicatedonthefinancials.h =F $F $  F  4    /   ______________________________  ________________ X -   F  4    /   ChiefFinancialOfficer   ?   Date H    A@?)6( dE6' A  (   N14 <DL!T$7% XN  PARTVIIIVERIFICATIONANDACKNOWLEDGMENT  7   0  STATEOF_____________________________  $ $    C    K   0  COUNTYOF___________________________  $ $ 0  Onthe______dayof_________________199__,beforemepersonallycameandappeared. $ $ 0  ___________________________________________________bymeknowntobesaidperson, l whosworeunderoathasfollows:\ $ $ 0  1. C He/sheis_____________________of_______________________________________g< $ $    C  (Printtitle) K      S (Printnameoffirm) W, 0  2.0C $ $He/sheisdulyauthorizestosignthisQuestionnaireonbehalfofsaidfirmanddulysigned 7  thisdocumentpursuanttosaidauthorization.'C $C $ 0  3. C TheanswerstothequestionssetforthinthisQuestionnairearetrue,accurateandcomplete. ! $ $ AB8  0  B8A4  .0C $ $  He/sheacknowledgedandunderstandsthattheQuestionnaireincludesprovisionswhichare !# deemedincludedintheContractifawardedtothefirm.B8Aی"$C $C $ Ќ  0  Sworntobeforemethis___________dayof________________,199__$!& $ $ 0  _________________________________________&l#( $ $   (NotaryPublic) '\$) {  #&B)%XXH#