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i rerracon <br />The Bidder as part of the bid package shall submit a list of a minimum of five (5) previous <br />asbestos, fungal and lead paint abatement projects of a similar scope and size, Succes5fully <br />completed by the Bidder along with the Owner's name, address and telephone number. If the <br />projects were handled by a consulting firm, the name, address, contact and telephone number <br />of the firm shall also be included. <br />LIST FIVE PREVIOUS HAZARDOUS MATERIAL ABATEMENT PROJECTS OF SIMILAR <br />SCOPE (highlight historical and municipal projects): <br />1. Owner: See attached <br />Contract Amount: <br />Consultant: <br />2. Owner: <br />Contract Amount: <br />Consultant: <br />3. Owner: <br />Contract Amount: <br />Consultant: <br />4 <br />Owner: <br />Contract Amount: <br />Consultant: <br />Phone No.: <br />Completion Date: <br />Phone No.: <br />Phone No.: <br />Completion Date: <br />Phone No.: <br />Phone No.: <br />Completion Date: <br />Phone No.: <br />Phone No.: <br />Completion Date: <br />Phone No.: <br />5. Owner: Phone No.: <br />Contract Amount: Completion Date: <br />Consultant: Phone No.: <br />ADDITIONAL ITEMS REQUIRED WITH BID: The following items are additionally required as <br />part of this bid submittal. <br />1. INSURANCE CERTIFICATES. <br />2. CONTRACTOR'S QUALIFICATION STATEMENT: Completed AIA Document A305. <br />3. A notarized statement, signed by an officer of the company, containing the following <br />information of a statement of negative of the same: <br />a) A record of citations issued by Federal, State, or Local regulatory agencies relating <br />to asbestos, fungal(mold) and lead paint abatement activity for the Contracting <br />company and any and ail affiliates. Include projects, dates and resolutions. <br />Kyle Bur ug s be Garrison <br />Texas Lic No. 10-5095 T xa icense No. 0107 <br />Expires 02 0.1 Ex es 11.10.12 <br />ID FORM FOR HAZARQOUS MATER[AL ABATEMENT - PAGE 4 <br />