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12. Background and experience of the principal members of your organization, including the <br />officers and the proposed project manager. L:. /-7 T---7-f-+C t-4 L. ~ <br />13. List two major suppliers from whom you purchase the majority of your supplies. <br />; <br />14. List two financial institutions with which you have established credit. <br />"4- (Q- <br />~ <br />r.- A r n ++-a i-..i. . - , ! !L i. .,(L.✓ iL l--l. ~-r i_i ~ . - 1 ✓ <br />15. State the name, address and phone number of each of your Workmen's Compensation <br />insurance carriers for the last 5 years. <br />16. List any claim made against you by your employees or third parties for personal injury, <br />death, or property damage in each of the last 3 years.~9 <br />17. List any and all litigation including arbitration, administrative proceedings, and mediation in <br />which you have been a plaintiff or defendant involving any owner, architect or engineer over <br />the past 5 years This list should be in sufficient detail to explain the positions of the various <br />parties and the ultimate outcome as to damages awarded (if any). 'I'his list shall be <br />considered material as respects the final awarding of any contract connected with the bid. <br />(state "none" or submit information on attached sheet. <br />18. The undersigned hereby authorizes and requests any person, firm, or corporation to furnish <br />any information requested by the OWNER in verification of the recitals comprising this <br />Contractor Application. <br />Dated at this Z /_o> day of 1-r; iziz ~Q- Y , 2010. <br />~ <br />Name of Bidder <br />, <br />By: <br />Title: <br />sr. C!0 0, 1.~- <br />