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Orange County DAA PN: R00592-226N <br />C&D Landfill Phase 2 Construction April 2021 <br /> BQS - 3/4 <br />7. List three material suppliers, including an individual's name and telephone number. <br /> <br /> a) <br /> <br /> b) <br /> <br /> c) <br /> <br /> <br />8. List bank references. Include an individual’s name and telephone number. <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />9. Bonding reference, name, address, telephone. <br /> <br /> <br /> <br /> <br /> <br />10. Are you on any list of debarred contractors maintained by the U.S. Department of Labor, <br />the U.S. Department of Housing and Urban Development or the North Carolina <br />Department of Transportation? <br /> Yes No <br /> <br />11. The undersigned hereby authorizes and requests any person, firm or corporation to furnish <br />any information requested by Draper Aden Associates in verification of the recitals <br />comprising this statement of contractor's qualifications. <br /> <br />12. State the true, exact, correct and complete name of the partnership, corporation or trade <br />name under which you do business, and the address of the place of business. (If a <br />corporation, state the name of the President and Secretary. If a partnership, state the <br />names of all partners. If a trade name, state the names of the individuals who do business <br />under the trade name.) It is absolutely necessary that this information be furnished. <br /> <br /> <br /> Correct Name of Bidder <br /> <br /> <br /> <br />DocuSign Envelope ID: 0844D1D6-E311-4FC5-8B5B-BB1E27A908ED