HomeMy WebLinkAboutO-1985-1476
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ORDINANCE NO. 1476
AN ORDINANCE REQUIRING THE PRE-QUALIFICATION OF CONTRACTORS ON
CITY OF LA PORTE CONSTRUCTION PROJECTS HAVING AN ESTIMATED COST
OF GREATER THAN THREE HUNDRED THOUSAND DOLLARS ( $300,000.00) ~
REQUIRING FILINGS OF CONTRACTOR'S STATEMENTS WITH THE CITY OF
LA PORTE: PROHIBITING CONTRACTORS FROM SUBCONTRACTING MORE THAN
FIFTY PERCENT (50%) OF WORK ON CITY OF LA PORTE PROJECTS WITHOUT
PRIOR WRITTEN CONSENT: REQUIRING ATTENDANCE AT A PRE-BID CONFER-
ENCE AS A PREREQUISITE TO SUBMITTING A BID: PROVIDING FOR PUBLI-
CATION OF NOTICE: APPROVING AND ADOPTING FORMS FOR THE PRE-
QUALIFICATION OF CONTRACTORS~ DEFINING "BIDDING CAPACITY": ADOP-
TING DISQUALIFICATION STANDARDS: FINDING COMPLIANCE WITH THE
OPEN MEETINGS LAW: AND PROVIDING AN EFFECTIVE DATE HEREOF.
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF LA PORTE:
Section 1. The City Council of the City of La Porte has de-
termined, and does hereby find, determine, and declare that it
is in the best interest of the City of La Porte that all Con-
tractors desiring to bid on City of La Porte construction projects
having an owner's estimated construction cost of greater than
Three Hundred Thousand Dollars ( $300,000.00), must pre-qualify
by filing a satisfactory Contractor's Statement, on the forms
attached hereto, with the Construction Project Manager, City of
La Porte, no later than fifteen days prior to the date bids are
to be opened, if a Contractor is to be eligible to bid. Thereafter,
a new Contractor's Statement shall be filed with the City annually.
The financial information contained in such Contractor's Statement
is deemed confidentia1~ shall not be disclosed by City to the
public or to other contractors: and shall be deemed exempt from
disclosure under the Open Records Act, Art. 6252-17a, V.A.T.S.,
in accordance with Texas Attorney General's Opinion No. ORD-309,
1982. The City Council of the City of La Porte finds that
disclosure of the financial information is likely to have either
of the following effects:
(1) to impair the City's ability to obtain necessary
information in the future: or
(2) to cause substantial harm to the competitive position
of the person from whom the information was obtained.
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ORDINANCE NO. 1476
Page 2
Section 2. Contractors entering bids on City of La Porte con-
struction projects shall not subcontract more than fifty percent
(50%) of the work on the project, without first obtaining the ex-
press written consent of the City of La Porte.
Section 3. All Contractors (or a representative of the contractor)
desiring to bid on City of La Porte construction projects must
attend a pre-bid conference: otherwise, such Contractor's bid
will be returned by the City unopened.
Section 4. Public notice of prequa1ification of bidders by the
City of La Porte, shall be published in like manner as invitations
to bidders, and shall not be a substitute for publishing the
actual invitation to bidders on each project.
Section 5. The City Council of the City of La Porte approves and
adopts the forms for Contractor's Statements, attached hereto as
Exhibit "A", incorporated by reference herein, and made a part
hereof for all purposes.
Section 6. The City of La Porte is interested in determining a
Contractor's "Bidding Capacity" for the purpose of issuing pro-
posa1s and awarding contracts. II Bidding Capaci ty" is determined
by multiplying the positive net working capital, as hereinafter
defined, by a factor determined by the City of La Porte. Only
those statements reflecting a positive net working capital po-
sition will be considered satisfactory for prequalification pur-
poses. "Positive Net Working Capita1" generally is represented
by the excess of current assets over current liabilities, as
shown by a balance sheet examined by an independent Certified
Public Accountant.
Section 7. The City Council of the City of La Porte adopts the
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ORDINANCE NO. 1476
Page 3
following standards for disqualification of Contractors:
I. AUTOMATIC DISQUALIFICATION
A. Company has no Positive Net Working Capital.
B. Company submits consolidated Statements.
C. Failure to complete Statements in all detail.
D. Company or personnel on Federal Job Debarment list.
E. Company or personnel on Justice Department list of un-
acceptable contractors: i. e. convicted of anti-trust
violations.
F. Failure to complete Statements in a truthful manner.
II. OTHER CONSIDERATIONS FOR POSSIBLE DISQUALIFICATION
A. Companies with pending litigation may be disqualified
for duration of litigation as deemed to the advantage
of the City by the City's Construction Project Manager.
B. Default on contract, or forfeiture of bid bonds or per-
formance bonds.
C. Performance record of poor workmanship on previous pro-
jects.
D. Performance record of failure to complete warranty work.
E. Bankruptcy or financial reorganization.
Section 8. The City Council officially finds, determines, re-
cites and declares that a sufficient written notice of the date,
hour, place and subject of this meeting of the City Council was
posted at a place convenient to the public at the City Hall of
the City for the time required by law preceding this meeting, as
required by the Open Meetings Law, Article 6252-17, Texas Revised
Civil Statutes Annotated~ and that this meeting has been open to
the public as required by law at all times during which this
Ordinance and the subject matter thereof has been discussed,
considered and formally acted upon.
The City Council further
ratifies, approves and confirms such written notice and the
contents and posting thereof.
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ORDINANCE NO.
Page 4
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Section 9. This Ordinance shall take effect and be in force
from and after its passage and approval.
PASSED AND APPROVED this the 28th day of October, 1985.
CITY OF LA PORTE
BY~~~
Norm Ma ne, ay r .
ATTEST:
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Cherie Black, City Secretary
APPROVED:
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Knox W. Askins,
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WARNING TO BIDDERS
The signatory of this Contractor's Statement guarantees, as
evidenced by the sworn affidavit required herein, the truth and
accuracy of all .statements and of all answers to the
interrogatories hereinafter made.
Before a contractor shall be considered eligible to bid on
owner's work of estimated construction cost of greater
than , he must have filed a satisfactory' contractor's
statement on this form, with the City of La Porte, Texas. This
statement shall be made as of the last day of any month, and
must be on file in the offices of the City of La Porte, at least
fifteen (15) days prior to the date bids are to be opened, if a
contractor is to be eligible to bid.
A new Contractor's Statement shall be made annually. If a
contractor has a satisfactory Contractor's Statement on file, he
will be eligible to bid for a period of twelve (12) months from
the date of the Contractor's Statement; however, City 'of La
Porte reserves the right to require a new contractor's statement
at any time. A contractor will be granted a three-month grace
period to prepare and submit a new Contractor's Statement,
provided he notifies the construction manager in writing, prior
to the date his Contractor's Statement expires, of his intention
to requalify.
It is clearly understood that if discrepancies are found in
this Contractor's Statement, the same will be considered
unsatisfactory, and the contractor will be ineligible to bid
until such discrepancies are satisfactorily explained to the
construction project manager.
In compiling the Contractor's Statement, all items must be
filled in and all schedules must be completed in detail. If
separate schedules are used, they must be specifically
identified as to which schedule in the Contractor's Statement
they support. FAILURE TO COMPLETE ALL ITEMS AND ALL SCHEDULES
IN DETAIL WILL DISQUALIFY THE CONTRACTOR, AND THE CONTRACTOR
WILL BE INELIGIBLE TO BID UNTIL A PROPERLY COMPLETED
CONTRACTOR'S STATEMENT HAS BEEN FILED WITH the City of La
Porte. If there is nothing to report in certain items or
schedules, then make the notation "None".
The amount as shown for each item must be actual, as taken
from company's books and verified, and must not be "approximate"
amounts.
A CONTRACTOR SUBMITTING A BID ON OWNER'S WORK SHALL ENTER A
BID WHICH STRICTLY CONFORMS TO THE PLANS AND SPECIFICATIONS OF
THE PROJECT AS ISSUED BY THE PROJECT'S ENGINEER(S).
CONTRACTORS ENTERING BIDS ON OWNER'S WORK SHALL HQI
SUBCONTRACT MORE THAN 50% OF WORK ON THE PROJECT, WITHOUT FIRST
OBTAINING THE EXPRESS WRITTEN CONSENT OF THE CITY OF LA PORTE.
All contractors (or a representative of the contractor)
desiring to bid on owner's work must attend a pre-bid
conference; otherwise, their bid will be returned unopened. No
plans and specifications shall be issued by the engineer(s)
after the pre-bid conference.
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INSTRUCTIONS
Please answer in complete detail all questions in the
Contractor's Statement. This applies particularly to dates
when contracts are expected to be comp1ete~, and dates when
notes or bills will become due or. must be paid. The
financial statement beginning on. page ~ of the
Contractor's Statement must show the cond~t10n of the
business as of the date noted in the caption. "Total
Assets" must equal "Total Liabilities" plus "Total Equity."
If there is not sufficient space in' the Contractor's
Statement, the use of attached schedules to support the
detailed information requested in the Contractor's Statement
will be satisfactoryJ however, it will be necessary to show
the dollar total opposite each heading and refer to a
specific schedule where the details pertaining to the item
total may be found. When attaching the schedules, please
furnish detailed addresses when they are requested in the
Contractor's Statement.
The proper authorization for verification and affidavit
on page of the Contractor's Statement must be executed
by the person or persons required to so execute and be
acknowledged by a notary public.
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CONTRACTOR'S STATEMENT
Date of Contractor's Statement
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Submitted to:
Name
Address
Telephone: ( )
Submitted by:
Legal name under which you wish to qualify
() Individual
() Partnership
() Joint Venture
() Corporation
() Other
Post Office Box
Zip Code
Street Address
Zip Code
City/State
Telephone
(
)
Texas Vendor Identification No.
Federal Employer's Identification No.
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EQUIPMENT AND EXPERIENCE STATEMENT
ORGANIZATIONAL BACKGROUND
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I.
If organization is a partnership:
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a. Date of Organization
b. State whether partnership is general or limited
Name
c. List ~ partners
Detailed Address
Tel. No.
Status
(general or
.. limited)
II. If organization is.a corporation:
a. Capital paid in cash, $
b. Date of Incorporation
c. State of Incorporation
d. Charter/permit number
e. Principal Place(s) of Business'
f. Other states in which corporation is legally authorized
to do business
9. President's name
h. Vice President's name
i. Secretary's name ___
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j.. Treasurer l s name
k. List ALL individuals owning 5% or more of the outstanding
stock of the corporation:
Name
Detailed Address
Te\. I, No.
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% of Stock
Owned
III. If organization is other than partnership or corporation:
a. Describe the organi.zation
b. List ~ principals of the organization
Name
Detailed Address
Tel. No.
Title
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IV. List ALL partners, principals, officers and field superintendents of the organization who have been
with the organization for less than five (5) years.
Name Employer(s) for From To Position Type of Business
past five (5) years
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V. Out of state activities:
a. List ALL states in which organization is legally authorized to do business ___
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b. List ALL corresponding registration/license numbers
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c. List ALL categories in which organization is legally authorized to do business ,
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d List ALL states in which partnership or trade name is filed
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Organization.s
Percentage
of Financial
Interest in
Other Business
Relationship
to
Organization
Type 0 f Bus i:ne.~~
List other businesses the organization is financially interested in:
Detailed Address Tel. No. Type of Business
List ALL affiliated and/or subsidiary companies
Detailed Address Tel. No
VI.
Name
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Name
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VIII.
How many rears has your organization been in business under its
present business name?
a.
Under what other or former names has your organization operated?
b.
Has your organization ever defaulted,
undergone reorganization procedures?
If so, please attach sheet discussing
creditors, amounts owed each, amounts
proceedings, etc.
decl~~ed bankruptcy or
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deta~ls, i.e., list of
repaid, resolution of
c. Has your organization's predecessors ever defaulted, declared
bankruptcy, or undergone reorganization procedures?
If so, please attach sheet discussing details.
d. Have any of your organization's affiliated/subsidiary companies
ever defaulted, declared bankruptcy or undergone ~eorganization?
If so, please attach sheet discussing details.
e. Does the organization presently have outstanding claims pending
against it? If so, attach sheet discussing details.
f. Do any of the organization's affiliated/subsidiary companies
have outstanding claims pending against it?
If so, attach sheet discussing details.
g. Is the organization currently involved in litigation?
If so, attach sheet disc~ssing details.
h. Are any of the organization's affiliated/subsidiary companies
currently involved in litigation? If so, attach
sheet discussing details.
CONSTRUCTION EXPERIENCE
IX. How many years has your organization been in business as a
general contractor under your present business name?
X.
How many years experience in
your organization had:
construction work has
a.
As a general contractor:
b.
As a subcontractor:
XI.
Equipment:
a.
List ALL heavy equipment which your organization presently owns.
Similar-types of equipment may be lUmped together. If your
organization has more than 20 types of equipment, list 20 and
show remainder as "Various".
Description of Equipment
Average Age
of Equipment
Quantity
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b. List all heavy equipment which is pertinent to the orqanization's
construction work that is not owned by the organization, but is
available by renting:
Description of Equipment
Name & Detailed Address of Owner
XII.
We normally perform the following work with our own forces:
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XIII. List ALL projects (not to exceed 20) of construction cost greater than $200,000 that your organization has
completed within the last five (5) years in Texas and elsewhere. (If requalifying, only. show work performed
since last statement).
IDeation
Scheduled City- Name and Name and detailed
Crnq>letion Date County- detailed address address of contractor Name and detailed
Name of Project J\m:)\.Ult Type of Work Date Canpleted State of project engineer (if sub-contractor) address of owner
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XIV. List major construction projects your organization has in process.
IDeation
Scheduled City- Name and Name and detailed
Calpletion County- detailed'address address of contractor Name and detailed
Name of Project J\m:)Wlt Type of Work Date State of project engineer (if sub-contractor) address of owner
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forfeited a bid bond/proposal guaranty,
If so, attach sheet detailing
name and detailed addresses of: (i) project
and (g) why.
lias your organization ever failed to complete a construction contract,
or otherwise refused to enter into contract for work awarded to it?
(a) name of project, (b) contract amount, (c) class of work, (d)
engineer, (ii) contractor, and (iii) owner, (e) when, (f) where,
xv.
Has any officer or partner of the organization ever been an officer or partner of some other organization that
failed to complete a construction contract, forfeited a bid bond/proposal guaranty, or otherwise refused to
enter into contract for work awarded to it? If so, attach sheet detailing (a
name of individual, (b) his current position; zation, (d) position at other
organization, (e) name of project, ,(f) when, (g
of otlier organ
and (h) why.
c J name
where,
XVI
Has any officer or partner of your organization ever failed to complete a construction contract, forfeited a
bid bond/proposal guaranty, or otherwise refused to enter into contract for work awarded to him in his own
name? --,~If so, attach sheet detailing (a) name of individual, (b) his current position, (c) class of
work, (d) name and detailed address, (e) when, (f) where, and (g) why.
XVII
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experience of the principal individuals of your organization. (Include not only officers of
but also field superintendents who will be in charge of the work).
List construction
the organization,
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I~ what capacity
Magnitude &
type of work
Years with
organization
Years of
construction
experience
Present
position or office
Name
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REFERENCES:
XIX. List ALL banks with whom your organization had done business with
during the past five years. List current bank first.
Name of Bank
Detailed
Address
Name of
Officer with
.1. whom you
tr~~~acted
b~S'tneSs
Tel. No.
xx. List ALL producers from whom your organization has purchased
principal materials during the last five years.
Name of Firm
Detailed Address
XXI. Payment and Performance Bond
a. Name and detailed address of insurance company:
1. Company file number:
2. Authorized to do business in Texas?
3. Authorized to issue payment/performance bonds?
4. Maximum amount of bond authorized to issue:
b. Name and detailed address of Agency (company or partnership
for which Agent works)
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1.. Name and detailed address of Agent (person actually signing
bonds)
5. Does agent/agency have appointment" from insurance company
authorizing agent/agency to sign bonds?
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FINANCIAL STATEMENT
Condition at close of business as of
, 19
ASSETS
Cash:
On Hand $
On Deposit: checking accounts $
On Deposit: other accounts $
Certificates of Deposit $
$
Bank & Detailed
Address
Deposited in
Name of
Maturity
Date
Amount
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$
TOTAL
(Cash)
Receivables:
Notes Receivable:
Due within 1 year
Due after 1 year
Past Due
$
$
$
$
Receivable From
Due Date
How Secured
Amount
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Accounts Receivable:
Subcontractors
$
$
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$
$
$ $
Construction Contracts -
Completed
Construction Contracts-
Incomplete
(sums earned to date)
Retainage Receivable
Non-construction Contracts
From affiliated companies
Receivable From
For What
Due Date
Amount
$
TOTAL
(Receivables)
Inventory:
Construction Materials on Job
Site $
Other Materials $
Work in Process $ $
TOTAL
(Inventory)
Equipment (book value) $ $
TOTAL
(Equipment)
Real Estate (appraised or book value):
Used for business purposes $
Used for non-business purposes $
Homestead $ $
TOTAL
(Real Estate)
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Other Assets:
Deposits on bids
$
Prepaid Expenses
amount to be consumed
in 12 mo.
amount to be consumed
after 12 mo.
Interest accrued on loans,
securities, etc.
$ ,
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$
Cash Value - Life Insurance $
Less: Policy Loans $
Stocks & Bonds (Market Value) $
Less: Income Tax on
Unrealized Gain $ $
Investments $
Insurance Deposits $
Other Deposits
$
$
TOTAL
(Other Assets)
TOTAL ASSETS
$
LIABILITIES
Notes Payable:
To Banks $
To Others for Equipment
Obligations $
To All Others $ $
To Whan
Detailed Address
Te%:m payrrentl CUrrent
Security Due Date Position
Imnmt
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TOTAL
(Notes Payable)
Accounts Payable:
Not Past Due
Past Due
$
$
$
To Whom
Detailed Address
For What
Date Payable
Amount
i
TOTAL
(Accounts Payable)
Equipment Lease (Rental)
Purchase Agreements
$
$
Payable to Whom
Minimum
Monthly Rental
Terms of Lease Agreement
$
TOTAL
(Equipment Lease)
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Accrued Expenses:
Payroll
$
$
$ -
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$ J
$
Payroll Taxes
Interest
Insurance
Federal Income Tax
Other
Advance Payments on Contracts
in Progress
$
TOTAL LIABILITIES
EQUITY
.
Corporate Equity
Common Stock $
Preferred Stock $
Paid In Surplus $
Appraisal Surplus $
Retained Earnings $
Retained Earnings Deficit $
Partnership Equity
$
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$
TOTAL
(Accrued Expenses)
$
TOTAL
(Advance Payments)
$
$
TOTAL
(Corp. Equity)
$
TOTAL
(Partnership Equity)
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Partner' s- Name
Amount
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Individual Equity
Net Worth
$
$
TOTAL
(Indiy. Equity)
TOTAL EQUITY
$
Has the organization satisfied ALL of its tax obligations as of the date
herein first given? - If not, attach sheet
discussing details 1 i.e., (1) to whom owned, (2) nature of tax
outstanding, (3) amount, (4) why, and (5) anticipated resolution of tax
debt.
Name and detailed address of individual accountant/accounting firm
preparing Financial Statement.
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FINANCIAL STATEMENT
Condition at close of business as of
ASSETS
Cash:
On Hand
On Deposit - checking accounts
On Deposit - other accounts
Certificates of Deposit
Receivables:
Notes Receivable:
Subcontractors $
Officers and Employees $
From Affiliated Companies $
Others
$
Accounts Receivable:
Retainage Receivable $
From Other Construction
Contracts $
From Affiliated Companies $
Other Accounts Receivable $
Subcontractors
$
Inventory:
Construction Materials
on Job Sites
Other Materials
Work in Process
Other Assets:
Deposits on Bids
Insurance Deposits
Other Deposits
Prepaid E~p~n~es
Stocks and Bonds - at Market
Less: provision for Income
Tax on Unrealized Gain
$
$
$
$
. Cash Value - Life Insurance
Less: Policy Loans
TOTAL ASSETS
.
$
$
$
$
$
$
$
$
.$
$
$
$
$
$
$
OPTION 2
.\ 07/22/85
, 19
$
$
$
$
$
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LIABILITIES
Notes Payable:
To Others - Secured
$
$
$
$
$
$
$
To Banks - Secured
For Equipment - Secured
To Banks - Unsecured
For Equipment - Unsecured
Lease (Rental) Purchase Agreements
To Others - Unsecured
Accounts Payable:
Trade Accounts $
Due Subcontractors - Estimates and Retainage $
Due Affiliates $
Other Accounts Payable $
Accrued Expenses:
Payroll
Interest
$
$
$
$
$
$
$
$
$
$
$
$
Payroll Taxes
Insurance
Federal Income Taxes
Other
Advance Payments
Corporate Equity
Partnership Equity
Individual Equity
TOTAL LIABILITIES
Has the organization satisfied ALL of its tax obligations as of the date
herein first given? - If not, attach sheet
discussing details1 i.e., (1) to whom owned, (2) nature of tax outstanding,
(3) amount, (4~ why, and (5) anticipated resolution of tax debt.
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07/22/85
FINANCIAL STATEMENT
Condition at close of business as of
, 19
ASSETS
Cash on hand and in banks $
Certificates of Deposit
(Due within one year) $
Notes Receivable (Due within one year) $
Accounts Receivable - Completed Contracts $
Accounts Earned on Incompleted Contracts $
Accounts Receivable - Others $
Inventory $
Equipment (book value) $
Real Estate (appraised or book value) $
Deposits (bid guarantees) $
Prepaid Expenses (Insurance,
Construction Bond, Interest,
Taxes, Others) $
Accrued Interest $
Cash Value of Life Insurance $
Stocks and Bonds - Listed (present value) $
Stocks and Bonds - Unlisted (present value) $
Other Assets $
TOTAL ASSETS $
LIABILITIES
Notes Payable - Banks $
- Equipment $
- Others $
Accounts Payable (Due within one year) $
Federal Income Tax provision $
Accrued Expenses $
Advance Payments on Contracts
In Progress $
Equipment Lease (Rental)
Purchas~ Agreements $
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Other Liabilities $
Corporate Equity $
P~rtnership Equity $
Individual Equity $
TOTAL LIABILITIES $
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OPTION '3
07/22/85
Has the organization sa~isfied ALL of its tax obligations as of the
date herein first given? - If not, attach sheet
discussing details1 i.e., (1) to whom owned, (2) nature of tax
outstanding, (3) amount, (4) why, and (5) anticipated resolution of
tax debt.
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INDIVIDUAL AUTHORIZATION FOR
VERIFICATION AND AFFIDAVIT
STATE OF
s
s
s
COUNTY OF
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The undersigned hereby declares that the )foregOing is a true
statement of the financial condition of the individual herein first
named, as of the date herein first given 1 that this statement is for the
express purpose of inducing the party to whom it is submitted to award
the submitter a contract 1 and that the accountant who prepared the
balance sheet accompanying this report as well as any depository, vendor
or any other agency herein named is hereby authorized to supply such
party with any information, while this statement is in force, necessary
to verify said statement.
, being duly sworn, deposes
and says that the foregoing financial statement, taken from his books, is
a true and accurate statement of his financial condition as of the date
thereof, and that the answers to the interrogatories contained therein
are true 1 that the statements and answers to the interrogatories of the
foregoing equipment questionnaire are correct and true as of the date of
this affidavit1 and, that the statements and answers to the
interrogatories of the foregoing expe~ience questionnaire are correct and
true as of the date of this affidavit.
SUBSCRIBED AND SWORN to by
undersigned authority, on this the day of
19 to certify which witness my hand and seal of office.
,
before
me,
the
,
Notary Public in and for
The State of Texas
Printed Name of Notary
My commission expires:
,
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PARTNERSHIP AUTHORIZATION
FOR VERIFICATION AND AFFIDAVIT
s
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STATE OF
COUNTY OF
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The undersigned hereby declares that the \tbregoing is a true
statement of the financial condition of the par11nership herein first
named, as of the date herein first given 1 that this statement is for the
express purpose of inducing the party to whom it is. submitted to award
the submitter a contract 1 and that the accountant who prepared the
balance sheet accompanying this report as well as any depository, vendor
or other agency herein named is hereby authorized to supply such party
with any information, while this statement is in force, to verify said
statement.
, being duly sworn,. .deposes and
says that he is a member of' the firm of 1.
that the foregoing financial statement, taken from the books of said
firm, is a true and accurate statement of the financial condition of said
firm as of the date thereof and that the answers to the interrogatories
contained therein are true and that the statements and answers to the
interrogatories of the foregoing equipment questionnaire are correct and
true as of the date of this affidavit1 and, that the statements and
answers to the interrogatories of the foregoing experience questionnaire
are correct and true as of the date of this affidavit.
Firm Name
of
the day of
witness my hand and seal of office.
SUBSCRIBED AND SWORN to by ,
before me, the undersigned authority, on this
, 19 to certify which
Notary Public in and for
The State of Texas
Printed Name of Notary
My commission expires:
-IS...
"
.
.
CORPORATION AU~HORIZATION
FOR VERIFICATION AND AFFIDAVIT
STATE OF
s
s
s
COUNTY OF
. 1
\ \
The undersigned hereby declares that the )foregOing is a true
statement of the financial condition of the corporation herein first
named, as of the date herein first given 1 that this statement is for the
express purpose of inducing the party to whom it is submitted to award
the submitter a contract 1 and that the accountant who prepared the
balance sheet accompanying this report ~s well as any depository, vendor
or other agency herein named is hereby authorized to supply such party
with any information, while this statement is in force, necessary to
verify said statement.
, being duly sworn, deposes and
says that he is of the ,
the corporation described in and which executed the foregoing statement 1
that he is familiar with the books of the said corporation showing its.
financial condition 1 that the foregoing financial statement taken from
the books of said corporation, is a true and accurate statement of the
financial condition of said corporation as of the date thereof and that
the answers to the interrogatories of the foregoing equipment
questionnaire are correct and true as of the date of this affidavit1 and,
that the statements and answers to the interrogatories of the foregoing
experience questionnaire are correct and true as of the date of this
affidavit.
(Officer must sign here)
SUBSCRIBED AND SWORN to by
undersigned authority, on this the day of
19 to certify which witness my hand and seal
,
before
me,
the
,
of
office.
Notary Public in and for
The State of Texas
Printed Name of Notary
My commission expires:
~16...