WA9302-CS 970401NATIONAL AMERICAN INSURANCE COMPANY
1008 Manvel Avenue
Chandler, Oklahoma 74834
GENERAL FORMS STATUS INQUIRY
DATE 4/1/97
OUR BOND NO. CB16368
YOUR NO. BID 3 Q1195-02
DYER STBET D~, ~ 75206
(INCLUDE L~ATIONAND OWNER'S C~CT NUMBER) ·
P~ P~ S~T~ON ~D~N PROJ ~A-9302
r(
we woul~l: information and return of this form at your early convenience.
· ~ Yours very truly.
itfl:~' KRISTIE
1.-IF C~CT COMPLETED, PLEASESTATE:
lApproximate Date Completion Notice Filed Date Final Payment Made
~Sat~fa~tod~ Comments
Q NO
3. ASSfGNMENTS OR LIENS ON FILE? Q Yes Q No (If yes, please explain In 4. below)
.. ', 'i~, ....~.,'~, '.,
III .
,l~m~thatklnfefmatloncent,insdherdn .~ 4. Remarka:(ifany)
~lshej'as a m,a~r ~ coufl~y for th~ conf,denUal use
.,- - - --~~~,:~ ,. _._, . _ ................. _, .__,,,,
~on~ la asmmed m, m result of r~lance by t~
-,'w~/, ~ ,u~ .Inform,Uon ,a fuml,h~d by the
owner or ilf an 'mrchitlt,,t or engineer as the agent of the
{writer. Date.
,., , L ,.
· ~'~ (RETURN ENVELOPE ENCLOSED)
Th~ language. of this form is:acceptable to The Surety Assodation
6/1/97