R2013-113 ACCEPTING THE BID AND AUTHORIZING A CONTRACT

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I ' 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 fonn by either typing�,rsuidses ing black ink Springfield,Illinois 62764 "Authorization to Bid"will not be issued unless bot of this form are completed in detail. Use additional forms as need 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 yet 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 bused 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 Awards Pending County and Section Number Cont maontence 72GO4 74299 Robinson ' Contract With IDOT IDOT MCCARTHY Feutz Estimated Completion Date 6114 12113 12/13 10/13 Total Contract Price Accumulated ' Uncompleted Dollar Va ue if Firm Is the 48,007.00 35,921.00 857,259.00 21,245.00 Totals 48,007.00 35,921.00 243,855.00 ncomp e e5iftoar Value if Firm Is the Subcontractor 321,960.00 21,245.00 1,069,963.00 Total Value of All Work 1,313,818.00 Part II. 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 48,007.00 35,921.00 321,960.00 21,245.00 1,313,818.00 ' 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 48,007.00 35,921.00 321,960.00 21,245.00 0.00 1,313,818.00 Disclosure of this information is REQUIRED to accomplish the statutory purpose as outlined in the"Illinois Procurement Code". Failure to 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 2 of 10 BC 57(06/09/08)