R2013-113 ACCEPTING THE BID AND AUTHORIZING A CONTRACT

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Illinois Department Affidavit of Availability of Transportation For the Letting of 10/31/2013 ' Bureau of Construction (Letting date) 2300 South Dirksen Parkway/Room 322 Instructions: Complete this form b either P y typing or using black ink. Springfield,Illinois 62764 "Authorization to Bid"will not be issued unless both sides of this form are completed in detail. Use additional forms as needed to list all work. Part I. Work Under Contract List below all work you have under contract as either a prime contractor or a subcontractor. It is required to include all pending low bids not ylet awarded or rejected. In a joint venture,list only that portion of the work which is the responsibility of your company. The uncompleted dollar value is to be biased upon the most recent engineer's or owners estimate,and must include work subcontracted to others If no work is contracted,show NONE. 1 2 3 4 Awardl Pending County and Section Number nco n eco ur 72961 Land Collecie 95696 Streetscape Contract With RW DUNTEMAN Lincoln Land FEUTZ FEUTZ Estimated Completion Date 09/14 12/13 03/14 8/13 ' Total Contract Price Accumulated 294,179.00 159,927.00 364,026.00 1,135,234.00 Totals Uncompleted Dollar Value if is the Prime Contractor 159,927.001 159,927.00 Uncompleted Dollar Value if Firm is the ' Subcontractor 297,179.001 1 272,274.00 157,305.00 726,758.00 Total Value of All Work 886,685.00 Part Il. Awards Pending and Uncompleted Work to be done with your own forces. ' List below the uncompleted dollar value of work for each contract and awards pending to be completed with your own forces. All work Accumulated subcontracted to others will be listed on the reverse of this form. In a joint venture,list only that portion of the work to be done by your company If no work is contracted,show NONE. Totals Earthwork 0.00 Portland Cement Concrete Paving 0.00 HMA Plant Mix 0.00 ' HMA Paving 0.00 Clean&Seal Cracks/Joints 0.00 Aggregate Bases&Surfaces 0.00 ' Highway,R.R.and Waterway Structures 0.00 Drainage 0.00 ' Electrical 297,179.00 159,927.00 272,274.00 157,305.00 886,685.00 Cover and Seal Coats 0.00 Concrete Construction 0.00 ' Landscaping 0.00 Fencing 0.00 ' Guardrail 0.00 Painting 0.00 Signing 0.00 Cold Milling,Planning&Rotomilling 0.00 Demolition 0.00 Pavement Markings(Paint) 0.00 'Other Construction(List) 0.00 0.00 0.00 Totals 297,179.00 159,927.00 272,274.00 157,305.00 0.00 886,685.00 Disclosure of this information is REQUIRED to accomplish the statutory purpose as outlined in the"Illinois Procurement Code". Failure tt comply will result ' in non-issuance of an"Authorization To Bid." This form has been approved by the State Forms Management Center, Printed 10/17/2013 Page 1 of 10 BC 57(06/09/08)