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{"sheet":"申請書（建①）","index":0,"n_rows":53,"n_cols":59,"rows_kept":53,"cut":false,"hidden":false,"merged":[[11,1,11,2],[11,3,11,4],[11,6,11,7],[11,9,11,10],[45,18,45,25],[26,11,27,21],[29,11,29,24],[48,15,48,19],[48,25,48,29],[18,11,18,50],[22,11,22,50],[23,11,24,50],[49,37,49,38],[49,47,49,48],[49,21,49,30],[47,12,47,20],[47,22,47,30],[48,35,48,39],[2,41,3,42],[2,44,3,46],[2,47,2,48],[2,49,2,50],[47,42,47,50],[48,45,48,49],[2,4,2,6],[3,4,3,6],[2,1,3,1],[2,8,2,12],[47,56,48,57],[5,1,6,62],[2,22,2,26],[3,22,3,26],[2,38,3,40],[47,32,47,40],[2,52,2,53],[2,55,2,56],[3,48,3,56],[43,18,43,40],[30,11,31,24],[30,37,31,50],[29,37,29,50],[36,33,36,48],[38,13,38,22],[19,11,20,50]],"flags":["formulas_cached_only"]}
["建①"]
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[null,"01",1,"：","新規",null,null,null,"＊02受付番号",{"$nulls":11},"＊","03","業者コード",{"$nulls":14},"＊","申請者の規模",{"$nulls":4},"＊","適格組合証明",null,null,"平成",null,null,null,"年",null,null,"月",null,null,"日"]
[null,null,2,"：","更新",{"$nulls":16},"04","建設業許可番号",{"$nulls":6},"－",{"$nulls":7},"05",{"$nulls":5},"06",null,null,null,"第",{"$nulls":9},"号"]
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[null,"　一般競争（指名競争）入札参加資格審査申請書（建設工事）"]
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[]
[null,"貴組合で行われる北但ごみ処理施設整備・運営事業に係る競争入札に参加する資格の審査を申請します。"]
[null,"なお、この申請書及び添付書類の内容については、事実と相違しないことを誓約します。"]
[]
[null,"平成",null,null,null,"年",null,null,"月",null,null,"日"]
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[null,null,null,"北但行政事務組合　管理者　中貝　宗治　様"]
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[null,null,"07","本社（店）郵便番号",{"$nulls":10},"－"]
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[null,null,null,"フリガナ"]
[null,null,"08","本社（店）住所"]
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[]
[null,null,null,"フリガナ"]
[null,null,"09","商号又は名称"]
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[null,null,"10","役職"]
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[null,null,null,"フリガナ",{"$nulls":28},"フリガナ"]
[null,null,null,"代表者氏名",{"$nulls":23},"㊞",null,null,null,"11","担当者氏名"]
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[null,null,"12","本社（店）電話番号",{"$nulls":27},"13","担当者電話番号"]
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[null,null,"14","本社（店）FAX番号",{"$nulls":23},"15","メールアドレス"]
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[null,null,"16","電子入札用ICカードの登録番号"]
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[null,null,"（17 代理申請時使用欄）"]
[null,null,"17","申請代理人",{"$nulls":7},"申請代理人 郵便番号",{"$nulls":9},"－",{"$nulls":7},"申請代理人 電話番号"]
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[{"$nulls":11},"申請代理人 氏名",{"$nulls":15},"㊞"]
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[null,null,"18","外資状況",{"$nulls":7},1,"外国籍会社",{"$nulls":8},2,"日本国籍会社",{"$nulls":8},3,"日本国籍会社",{"$nulls":19},"19","営業年数"]
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[{"$nulls":52},"20","総従業員数"]
[{"$nulls":54},"（人）"]
[null,null,null,"*欄については、記載しないこと。（以下同じ。）"]

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["建②"]
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[null,"＊受付番号"]
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[null,"完　　　成　　　工　　　事　　　高","①","競争参加資格希望工種区分",{"$nulls":8},"②年間平均完成工事高",{"$nulls":9},"③監理技術者数"]
[]
[]
[]
[{"$nulls":12},"（千円）",{"$nulls":9},"（人）"]
[null,null,"01","土木一式"]
[null,null,"02","建築一式"]
[null,null,"03","大工"]
[null,null,"04","左官"]
[null,null,"05","とび・土工・コンクリート"]
[null,null,"06","石"]
[null,null,"07","屋根"]
[null,null,"08","電気"]
[null,null,"09","管"]
[null,null,"10","タイル・れんが・ブロック"]
[null,null,"11","鋼構造物"]
[null,null,"12","鉄筋"]
[null,null,"13","ほ装"]
[null,null,"14","しゅんせつ"]
[null,null,"15","板金"]
[null,null,"16","ガラス"]
[null,null,"17","塗装"]
[null,null,"18","防水"]
[null,null,"19","内装仕上"]
[null,null,"20","機械器具設置"]
[null,null,"21","熱絶縁"]
[null,null,"22","電気通信"]
[null,null,"23","造園"]
[null,null,"24","さく井"]
[null,null,"25","建具"]
[null,null,"26","水道施設"]
[null,null,"27","消防施設"]
[null,null,"28","清掃施設"]
[null,null,"29","その他"]
[null,null,"30","合　　計"]
[null,"０１～２９の実人数"]
[null,null,"注１　　完成工事高については、消費税を含まない金額を記載すること。"]
[null,null,"注２　　監理技術者数は、総合評定値通知書に記載された技術職員数のうち、監理技術者資格者証を有する者の数を"]
[null,null,"　　 　　記入すること。"]

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["建③"]
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[null,"*","受付番号"]
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[null,"工　　事　　経　　歴　　書"]
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[null,"（建設工事の種類）",{"$nulls":14},"工事"]
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[null,"発　注　者",{"$nulls":10},"元請又は\n下請の別",null,null,null,"工　事　名　",{"$nulls":15},"工事場所のある都道府県名",{"$nulls":4},"請負代金の額",{"$nulls":5},"着　工　年　月"]
[{"$nulls":37},"（千円）",{"$nulls":5},"完成（予定）年月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[{"$nulls":43},"平成",null,null,null,"年",null,null,"月"]
[null,"記載要領"]
[null,null,1,null,"本表は、許可を受けた建設業の種類に対応した建設工事の種類ごとに作成すること。"]
[null,null,2,null,"本表は、直前2年間の主な完成工事及び直前2年間に着手した主な未完成工事について記載すること。"]
[null,null,3,null,"下請工事については、「発注者」　の欄には元請業者名を記載し、「工事名」の欄には下請工事名を記載すること。"]
[null,null,4,null,"「請負代金の額」は、消費税込みの金額を記載すること。"]

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["建④"]
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[null,"*","受付番号"]
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[null,"技　　術　　者　　経　　歴　　書"]
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[null,"（種類）"]
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[null,"氏　名",{"$nulls":4},"最終学歴",{"$nulls":9},"法令による免許等",{"$nulls":15},"実　務　経　歴",{"$nulls":14},"実務経験年月数"]
[{"$nulls":6},"学校の種類",{"$nulls":4},"専攻学科",{"$nulls":4},"名　　称",{"$nulls":7},"取得年月日"]
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[{"$nulls":27},"年",null,"月",null,"日",{"$nulls":17},"年",null,null,"月"]
[{"$nulls":27},"年",null,"月",null,"日",{"$nulls":17},"年",null,null,"月"]
[{"$nulls":27},"年",null,"月",null,"日",{"$nulls":17},"年",null,null,"月"]
[{"$nulls":27},"年",null,"月",null,"日",{"$nulls":17},"年",null,null,"月"]
[{"$nulls":27},"年",null,"月",null,"日",{"$nulls":17},"年",null,null,"月"]
[{"$nulls":27},"年",null,"月",null,"日",{"$nulls":17},"年",null,null,"月"]
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[null,"記載要領"]
[null,1,"本表は、工種・職種等の各別に作成する。"]
[null,null,"また、「氏名」の記載は、営業所（本店又は支店若しくは常時契約する事務所）ごとにまとめて行い、その直前に、（　）書きで当該営業所名を記載すること。"]
[null,2,"「学校の種類」の欄には、大学、高等専門学校等の別を記載すること。"]
[null,3,"「法令による免許等」の欄には、業務に関し法律又は命令による免許又は技術若しくは技能の認定を受けたものを記載すること。"]
[null,4,"「実務経歴」の欄には、最近のものから記載し、従事した職種及び地位を記載すること。"]

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["建⑤"]
[]
[null,"*","受付番号"]
[]
[null,"営　　業　　所　　等　　一　　覧　　表"]
[]
[]
[]
[null,"番号",null,"本社・本店、支店・営業所等",{"$nulls":7},"郵便番号",{"$nulls":7},"所在地",{"$nulls":14},"電話番号（上段）",{"$nulls":11},"許可を受けた建設業の種類"]
[null,null,null,"　　　　　　　　　　　　の名称",{"$nulls":42},"01","02","03","04","05","06","07","08","09","10","11","12","13","14","15","16","17","18","19","20","21","22","23","24","25","26","27","28"]
[null,null,null,"代表者又は受任者",{"$nulls":30},"FAX番号（下段）",{"$nulls":11},"土","建","大","左","と","石","屋","電","管","タ","鋼","筋","舗","しゅ","板","ガ","塗","防","内","機","絶","通","園","井","具","水","消","清"]
[]
[null,"本社・本店",{"$nulls":12},"－",{"$nulls":7},"都道府県"]
[]
[null,"支店・　　　　　　　　　　　　営業所等",{"$nulls":12},"－",{"$nulls":7},"都道府県"]
[]
[]
[]
[null,"記載要領"]
[null,null,1,null,"本表は、申請日現在で作成すること。"]
[null,null,2,null,"「支店・営業所等」欄には、申請を希望する工事の種別について、組合と常時契約の締結ができる権限を委任された支店・営業所等について記入すること。"]
[{"$nulls":4},"（工種に対応する許可が必要です。なお、常時契約の締結ができる権限のない単なる連絡所は登録することはできません。）"]
[null,null,3,null,"「所在地」欄には、所在地を上段から左詰めで記載すること。"]
[null,null,4,null,"「電話番号・FAX番号」欄には、上段に電話番号を、下段にFAX番号を記載し、市外局番、市内局番及び番号は「－（ハイフン）」で区切ること。"]
[null,null,5,null,"「許可を受けた建設業の種類」欄には、「本社・本店、支店・営業所等の名称」欄に記入した本社・本店、支店・営業所等が許可を受けている建設業の許可の欄に"]
[{"$nulls":4},"一般建設業の場合は｢１｣を、特定建設業の場合は｢２｣を付すること。"]
[{"$nulls":4},"（01＝土木工事業、02＝建築工事業、03＝大工工事業、04＝左官工事業、05＝とび・土工工事業、06＝石工事業、07＝屋根工事業、08＝電気工事業、09＝管工事業、10＝タイル・れんが・ブロック工事業、"]
[{"$nulls":4},"11＝鋼構造物工事業、12＝鉄筋工事業、13＝ほ装工事業、14＝しゅんせつ工事業、15＝板金工事業、16＝ガラス工事業、17＝塗装工事業、18＝防水工事業、19＝内装仕上工事業、、20＝機械器具設置工事業、"]
[{"$nulls":4},"21＝熱絶縁工事業、22＝電気通信工事業、23＝造園工事業、24＝さく井工事業、25＝建具工事業、26＝水道設備工事業、27＝消防施設工事業、28＝清掃施設工事業）"]

{"sheet":"委任状（共①）","index":5,"n_rows":37,"n_cols":1,"rows_kept":37,"cut":false,"hidden":false,"merged":[],"flags":["formulas_cached_only"]}
["共①"]
["委　　　任　　　状"]
[]
["平成　　年　　月　　日"]
[]
[]
[]
["北但行政事務組合"]
["管理者　中　貝　宗　治　　様"]
[]
[]
["　私は、下記の者を代理人と定め、下記の権限を委任します。"]
[]
["記"]
[]
["  １　入札および見積に関する件"]
["  ２　契約締結に関する件"]
["  ３　保証金の納付ならびに還付金の受領に関する件"]
["  ４　契約履行に関する件"]
["  ５　契約代金の請求および受領に関する件"]
["  ６　上記各号に関し復代理人選任及び解任に関する件"]
["  ７　期間　　　自　平成２５年　１月１６日"]
["　　　　  　　　至　平成２６年　３月３１日"]
[]
[]
[]
["  ■委任者"]
["　  　所在地又は住所"]
["　  　商号又は名称"]
["　  　代表者氏名　　　　　　　     　　　　　　　　　　　　　㊞　　"]
[]
["上記、委任の件承諾します。"]
[]
["  ■受任者"]
["  　　所在地又は住所"]
["  　　商号又は名称"]
["　  　受任者氏名　　　　　　　　　　     　　　　　　　　　　㊞　　"]

{"sheet":"受付証（共②）","index":6,"n_rows":52,"n_cols":8,"rows_kept":52,"cut":false,"hidden":false,"merged":[[47,0,50,0],[51,0,54,0],[51,1,54,3],[51,4,54,6],[51,7,54,9],[29,0,29,10],[32,0,32,9],[33,0,33,9],[35,7,35,9],[37,6,39,6],[43,1,46,9],[44,0,46,0],[9,1,9,2],[12,7,12,9],[13,7,13,9],[14,0,17,0],[18,0,21,0],[18,1,21,3],[18,4,21,6],[18,7,21,9],[1,0,1,9],[2,0,2,9],[4,0,4,9],[5,0,5,9],[7,1,7,2],[8,1,8,2]],"flags":["formulas_cached_only"]}
["共②"]
["平成24・25年度　北但行政事務組合"]
["入札参加資格審査申請書 受付証（申請者保管用）"]
[]
["　　　　　　　　　　　　　　　　　　建設工事を申請される方は、毎年決算確定後すみやかに"]
["　　　　　　　　　　　　　　　　　　経営事項審査を受けることが条件となります。　　　　"]
[]
["申請者","所在地又は住所"]
[null,"商号又は名称"]
[null,"代表者"]
[]
[]
["あなたから申請のあった入札参加資格審査申請書を受付しました。",{"$nulls":6},"平成　　年　　月　　日"]
[{"$nulls":7},"北但行政事務組合"]
["受付　　　　番号"]
[]
[]
[]
["受付　　　　　　　　　者印","建設工事",null,null,"測量・建設コンサルタント等",null,null,"物品製造・役務の提供等"]
[]
[]
[]
[]
["記載要領"]
["１ 受付証及び受付票には、本店の所在地又は住所、商号又は名称及び代表者氏名を記入してください。"]
["２ この用紙の太線内は、記入しないでください。"]
["３ 記入する文字は、かい書でわかりやすく書いてください。"]
["４ 代表者印の押印の必要はありません。"]
[]
["（切り取らないでください）"]
[]
[]
["平成24・25年度　北但行政事務組合"]
["入札参加資格審査申請書 受付票（組合保管用）"]
[]
[{"$nulls":7},"平成　　年　　月　　日"]
[]
["商　号",{"$nulls":5},"代表者"]
["又　は"]
["名　称"]
["所在地"]
["又　は"]
["住　所"]
["提出書類","１．建設工事　　　２．測量・建設コンサルタント等　　　３．物品製造・役務の提供等"]
["※該当番号を○で囲む"]
[]
[]
["受付　　　　番号"]
[]
[]
[]
["申請　　　　　　　　書類　　　　　　　　　受領印","建設工事",null,null,"測量・建設コンサルタント等",null,null,"物品製造・役務の提供等"]

{"sheet":"提出書類チェック表","index":7,"n_rows":27,"n_cols":5,"rows_kept":27,"cut":false,"hidden":false,"merged":[[20,4,24,4],[0,0,0,4],[3,0,3,1],[3,2,4,2],[3,3,4,3],[3,4,4,4],[15,0,19,0],[15,1,19,1],[15,2,19,2],[15,3,19,3],[20,0,24,0],[20,1,24,1],[20,2,24,2]],"flags":["formulas_cached_only"]}
["提出書類チェック表（製本するファイルの表紙裏側に貼付）"]
[]
["《建設工事》　★印の書類は必ず組合様式を使用すること"]
["チェック欄",null,"書類番号","書類名","備考"]
["申請者","組合"]
[null,null,1,"一般競争（指名競争）入札参加資格審査申請書","組合様式（建①）又は中央公契連統一様式"]
[null,null,2,"完成工事高表★","組合様式（建②）"]
[null,null,3,"工事経歴書","組合様式（建③）又は中央公契連統一様式"]
[null,null,4,"技術者経歴書","組合様式（建④）又は中央公契連統一様式"]
[null,null,5,"営業所等一覧表（営業所等がない（委任をしない）場合は本社のみ記載）","組合様式（建⑤）又は中央公契連統一様式"]
[null,null,6,"総合評定値通知書","申請をする直前に受けたものであり、決算日から１年７ヶ月以内の有効なもの"]
[null,null,7,"使用印鑑届","任意様式"]
[null,null,8,"委任状★（※代理人を選任する場合のみ）","組合様式（共①）"]
[null,null,9,"建設業許可証明書又は許可通知書","写し可"]
[null,null,10,"建設業退職金共済事業加入・履行証明書","建設業、清酒製造業、林業退職金共済組合が証明するもの（写し可）"]
[null,null,11,"納税証明書　　　　　　　　　　　　　　　　　　　　　　　　　　(未納税額がないことを証明するもの)","■書式その３関係…税務署で発行　写し可"]
[{"$nulls":4},"【法人の場合】"]
[{"$nulls":4},"　法人税並びに消費税及び地方消費税　　　　　　　　　　　　　　　　（様式その３の３）"]
[{"$nulls":4},"【個人の場合】"]
[{"$nulls":4},"　申告所得税並びに消費税及び地方消費税　　　　　　　　　　　　　　　　　　　　　　　　（様式その３の２）"]
[null,null,12,"【法人の場合】　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　","写し可"]
[null,null,null,"　商業登記簿謄本"]
[null,null,null,"【個人の場合】　　　　　　　　　　　　　　　　　　　　　　　　　　　"]
[null,null,null,"　身分証明書（本籍地の市区町村で発行）及び"]
[null,null,null,"　代表者の住民票"]
[null,null,13,"入札参加資格審査申請書受付証　　　　　　　　　　　　　　　　　　　　　　　　　　（受付証に本受付印を必要とする場合のみ）　　　　　　　","組合様式（共②）又は任意様式"]
[null,null,14,"返信用封筒（受付証に本受付印を必要とする場合のみ）","任意様式（切手貼付・宛名記載）"]