NOTICE OF INTENT TO SUBMIT PROPOSAL

JOB NO._____________

Manager-Chief Engineer Date

Department of Water Supply

County of Hawai‘i Telephone: (808) 961-8050

345 Kekūanaō‘a Street, Suite 20 Facsimile: (808) 961-8657

Hilo, HI 96720

Dear Sir:

In accordance with the provisions of Section 103D-310, Hawai‘i Revised Statues, you are hereby notified that it is the intent of the undersigned to submit a proposal on

Job No.

for which deadline for proposals will be _________p.m.,

The undersigned is qualified to perform this work under Section 444, Hawai‘i Revised Statutes, and any amendments thereto.

I will submit my proposal to (check one only):

_____ Manager-Chief Engineer’s Office, Department of Water Supply

345 Kekūanaō‘a Street, Suite 20, Hilo, Hawai‘i 96720

_____ Office of the Mayor, West Hawai‘i Civic Center

74-5044 Ane Keohokalole Highway

Building C, 2nd Floor

Kailua-Kona, Hawai‘i 96740

Yours very truly,

_____________ ______________

Contractor’s Expiration Date Signature

License No.

(_____) _______________________

Telephone No. Name and Title of Signer

(_____) _______________________

Facsimile No. Name of Firm

Address

City State Zip Code