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{"sheet":"③ 【建設工事】申請方法","index":0,"n_rows":55,"n_cols":17,"rows_kept":55,"cut":false,"hidden":false,"merged":[[18,6,18,10],[34,2,34,3],[19,4,27,4],[19,5,27,5],[19,6,20,10],[21,6,27,10],[28,2,28,3],[28,6,28,11],[19,2,27,3],[29,6,29,11],[0,1,0,11],[2,2,11,10],[41,6,41,8],[43,6,43,10],[15,2,16,3],[14,6,14,10],[14,2,14,3],[15,4,16,4],[15,5,16,5],[34,6,34,11],[54,1,54,11],[37,5,39,5],[37,3,39,3],[40,3,43,3],[40,4,43,4],[40,5,43,5],[44,4,46,4],[44,5,46,5],[44,6,46,10],[37,4,39,4],[48,2,49,3],[48,4,49,4],[48,5,49,5],[48,6,49,11],[37,2,46,2],[44,3,46,3],[38,6,38,10],[47,6,47,11],[30,2,30,3],[30,6,30,11],[29,2,29,3],[37,6,37,10],[31,2,33,3],[31,4,33,4],[31,5,33,5],[31,6,33,11],[36,9,36,10],[35,6,35,10]],"flags":["formulas_cached_only"]}
[null,"令和７・８・９年度　建設工事入札（見積）参加資格審査申請要領"]
[]
[null,null,"　令和７・８・９年度において青木村が発注する建設工事の競争入札（見積）に参加を希望する方は、下記により「入札参加資格審査申請書」を提出してください。\n\n（1）提出書類の内容を審査し、入札参加資格があると認められた者については、入札参加資格登録業者名簿に登載します。申請がない場合には原則的に入札（見積）指名はしませんのでご注意ください。\n（2）入札参加資格登録の有効期間は、令和７年４月1日から令和１０年３月31日までです。\n（3）村内事業者の方は村に関する公租公課金の完納が必須条件ですのであわせてご確認ください。\n　※詳しい内容説明や申請様式が必要な場合は財政係までご照会ください。"]
{"$rows_empty":10}
[null,"■提出書類一覧表"]
[null,null,"提出書類",null,"法人","個人","備　　　考",{"$nulls":9}," "]
[null,null,"   1.入札参加資格審査申請書",null,"〇","〇","宛先は、「青木村長」とする"]
[{"$nulls":6},"実印又は取引使用印を押印"]
[null,null,"   2.委任状　　　　",null,"△","△","支店、営業所等に取引上の権限を委任する場合に提出してください。（任意様式可）"]
[null,null,"   3.誓約書　　　　　　　　",null,"〇","〇","本店で作成し、実印を押したものを提出してください。"]
[null,null,"   4.社会保険等加入状況申出書\n\n    ※加入義務がない場合は、\n　    社会保険に加入義務がない\n       ことについての申出書\n\n",null,"△","〇","経営規模等評価結果通知書・総合評定値通知書で社会保険等の欄が無になっている場合のみ提出してください。"]
[]
[{"$nulls":6},"【添付書類】\n・厚生年金保険及び健康保険の加入が確認できない場合は、「健康保険・厚生年金保険の領収証書」、「社会保険料納入証明書」、「健康保険・厚生年金保険資格取得確認及び標準報酬決定通知書」のいずれかの写し\n\n・雇用保険の加入が経営事項審査の総合評定値通知書で確認できない場合は、「労働保険概算・確定保険料申告書」及び「雇用保険被保険者資格取得等通知書」の写し\n\n・厚生年金保険及び健康保険の加入義務がないこと又は雇用保険の加入義務がないことが経営事項審査の総合評定値通知書で確認できない場合は、「賃金台帳・労働者名簿・源泉所得税領収書等」のうちいずれかの写し\n"]
[]
[]
[]
[]
[]
[]
[null,null,"   5.営業所一覧",null,"△","△","（任意様式可）"]
[null,null,"   6.建設工事経歴書",null,"〇","〇","直前2年間の各営業年度における工事経歴書を業種別に作成してください。（任意様式可)"]
[null,null,"   7.技術者経歴書（名簿）",null,"〇","〇","（任意様式可）"]
[null,null,"   8.経営事項審査結果通知書又は\n     総合評定値通知書（写し）",null,"△","△","有効期限内で、最新なものを提出してください。\n※決算時期等により申請年度の日付でない場合は、前年度のものを添付し、後日提出（郵送可）すること。"]
[]
[]
[null,null,"   9.建設業許可等の証明書（写し）",null,"△","△","希望する業種の有効期限内で、最新のものを提出してください。"]
[null,null," 10.登記簿謄本（写可）",null,"〇",null,"商業登記簿謄本（履歴事項全部証明書、現在事項全部証明書でも可）\n（発行日が3か月以内のもの）"]
[null,null," 11.身分証明書（写可）",null,null,"〇","代表者本籍地の市村村長が発行する証明書",null,null,"（発行日が3か月以内のもの）"]
[null,null," 12.納税証明書\n             （写可）\n\n ※申請日の直前の\n   営業年度\n\n（発行日が3か月以内のもの）","国税","〇","〇","（法人事業者）法人税、消費税及び地方消費税"]
[{"$nulls":6},"（個人事業者）申告所得税及び復興特別所得税と消費税及び地方消費税"]
[{"$nulls":6},"　※本社所在地の税務署が発行する未納税額がないことの証明書"]
[null,null,null,"都道府県税","〇","〇","法人事業税（法人事業者）"]
[{"$nulls":6},"個人事業税（個人事業者）"]
[{"$nulls":6},"本社所在地の都道府県が発行する未納税額がないことの証明書"]
[{"$nulls":6},"※委任先を設ける場合は、委任先住所のもの（この場合委任先所在地のものだけで可）"]
[null,null,null,"村税","△","△","完納証明書　…村内業者は必須\n　※委任先の有無にかかわらず、青木村に納税義務がある場合も必要。　\n　※個人事業者にあっては、代表者の完納証明書"]
[]
[]
[null,null," 13.印鑑登録証明書（写可）",null,"〇","〇","法人の場合は法務局、個人の場合は市区村村で3か月以内に発行されたものを提出してください。"]
[null,null," 14.使用印鑑届",null,"△","△","入札契約時に実印以外の印鑑を使用する場合は提出してください。（任意様式）"]
[]
[]
[null,null,"※　〇は必ず提出　△は該当する場合のみ提出"]
[null,null,"※　1.3.4の提出書類は、村指定の様式で提出してください。"]
[]
[null,"クリアファイル（透明）に入れて提出してください"]

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["（様式１）"]
[]
["令和７・８・９年度建設工事入札（見積）参加資格審査申請書"]
[]
[{"$nulls":18},"令和",null,null,"年",null,"月",null,"日"]
[null,"青木村長　　北村　政夫　様"]
[]
[null,null,"この申請書及び添付書類の記載事項は、事実と相違ないことを誓約します。"]
[]
[null,"1　申請者（本社）"]
[null,null,"フリガナ"]
[null,null,"商号又は名称"]
[]
[null,null,"所在地",{"$nulls":4},"〒","　　　　-　"]
[]
[null,null,"代表者役職",{"$nulls":11},"氏名",{"$nulls":10},"実印"]
[]
[null,null,"電話番号",null,null,null,"（　　　）　　　－",{"$nulls":7},"FAX番号",null,null,null,"（　　　）　　　－"]
[]
[]
[null,"2　委任先"]
[null,null,"フリガナ"]
[null,null,"名称"]
[]
[null,null,"所在地",{"$nulls":4},"〒　　　－","　　　　-　"]
[]
[null,null,"代表者役職",{"$nulls":11},"氏名",{"$nulls":10},"印"]
[]
[null,null,"電話番号",null,null,null,"（　　　）　　　－",{"$nulls":7},"FAX番号",null,null,null,"（　　　）　　　－"]
[]
[]
[null,"3　申請書に関する問い合わせ先"]
[null,null,"担当者名",{"$nulls":11},"電話番号",null,null,null,"（　　　）　　　－"]
[]
[]
[null,"※　行政書士記入記入欄【行政書士が申請書類を作成した場合のみ記入】"]
[null,null,"行政書士事務所名",{"$nulls":11},"電話番号",null,null,null,"（　　　）　　　－"]
[]
[]
[]
[]
[null,"4　入札参加を希望する業種"]
[null,null,"（1）入札参加を希望する建設工事の種類、建設業許可区分、実績について記入してください。"]
[null,null,"（2）委任先を設けている場合は委任先について記入してください。"]
[{"$nulls":4},"種類",{"$nulls":5},"入札参加希望\n（該当に〇）",null,null,null,"建設業許可区分\n（該当に〇）",{"$nulls":5},"年間平均工事実績（千円）\n（直前2年間の平均）"]
[]
[null,null,1,null,"土木一式",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,2,null,"建築一式",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,3,null,"大工",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,4,null,"左官",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,5,null,"とび・土工・コンクリート",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,6,null,"石",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,7,null,"屋根",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,8,null,"電気",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,9,null,"菅",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,10,null,"タイル・れんが・ブロック",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,11,null,"鋼構造物",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,12,null,"鉄筋",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,13,null,"ほ装",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,14,null,"しゅんせつ",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,15,null,"板金",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,16,null,"ガラス",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,17,null,"塗装",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,18,null,"防水",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,19,null,"内装",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,20,null,"機械器具",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,21,null,"熱絶縁",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,22,null,"電気通信",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,23,null,"造園",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,24,null,"さく井",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,25,null,"建具",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,26,null,"水道",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,27,null,"消防",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,28,null,"清掃",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[null,null,29,null,"解体",{"$nulls":5},"あり・なし",null,null,null,"特定・一般・なし",{"$nulls":10},"千円"]
[]
[]
[null,"5　会社概要"]
[null,null,"（1）建設業許可区分"]
[null,null,"許可",null,null,"大臣・知事",{"$nulls":4},"許可番号　　第　　　　　　号",{"$nulls":7},"許可日　　年　　月　　日"]
[]
[]
[null,null,"（2）従業員数（上欄は、会社全体の人数、下欄は委任先の人数を記入してください）"]
[null,null,"全従業員数",null,null,null,"人　",{"$nulls":7},"うち技術職員数",null,null,null,"人　"]
[]
[null,null,"委任先従業員数",null,null,null,"人　",{"$nulls":7},"うち技術職員数",null,null,null,"人　"]
[]
[]
[null,null,"（3）営業年数"]
[null,null,"営業年数",null,null,null,"年　"]

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["（様式第２号）",{"$nulls":12},"（用紙Ａ４）"]
[null,null,null,"技　術　者　経　歴　書"]
[]
[null,"建設工事の種類"]
[null,"氏　　名",null,"年齢","法令による免許等",null,null,"技術修得課程",null,"実務経歴",null,"経　験　　　年月数","技術者該当区分(○印)"]
[null,"（生年月日）",null,null,"有資格名称","取得年月","交付番号等","学校名","専攻学科",null,null,null,"主任技術者","管理技術者"]
[{"$nulls":11},"　年　月"]
[]
[{"$nulls":11},"　年　月"]
[]
[{"$nulls":11},"　年　月"]
[]
[{"$nulls":11},"　年　月"]
[]
[{"$nulls":11},"　年　月"]
[]
[{"$nulls":11},"　年　月"]
[]
[{"$nulls":11},"　年　月"]
[]
[{"$nulls":11},"　年　月"]
[]
[{"$nulls":11},"　年　月"]
[]
[{"$nulls":11},"　年　月"]
[]
[null,"（記載要領）"]
[null,null,"※実際に雇用している資格者について、すべての資格を記載してください。"]
[null,null,"※雇用保険料等の納付状況が確認できる書類(写し可）を添付してください。"]
[null,null,"※会社として所有する許認可資格等についても適宜記載してください。"]
[null,null,"※実務経験により「主任技術者」の要件を有する者などについても適宜記載してください。"]

{"sheet":"【建設工事】様式3（建設工事経歴書）","index":3,"n_rows":30,"n_cols":15,"rows_kept":30,"cut":false,"hidden":false,"merged":[[25,8,25,9],[15,8,15,9],[16,8,16,9],[17,8,17,9],[18,8,18,9],[19,8,19,9],[13,8,13,9],[14,8,14,9],[21,8,21,9],[22,8,22,9],[23,8,23,9],[24,8,24,9],[4,10,4,12],[4,13,5,13],[6,8,6,9],[7,8,7,9],[8,8,8,9],[20,8,20,9],[9,8,9,9],[10,8,10,9],[11,8,11,9],[12,8,12,9],[4,1,5,2],[4,4,5,6],[1,3,1,7],[3,1,3,2],[3,3,3,5],[4,8,5,9]],"flags":["formulas_cached_only"]}
["（様式第３）",{"$nulls":13},"（用紙Ａ４）"]
[null,null,null,"建設工事経歴書"]
[]
[null,"建設工事の種類"]
[null,"注文者",null,"元負又は","件名",null,null,"業務履行場所","測量等の対象の規模",null,"請負代金の額",null,null,"着工年月","完成又は　　"]
[null,null,null,"下請の別",null,null,null,"の県市町村名",null,null,null,"（千円）",null,null,"完成予定年月"]
{"$rows_empty":20}
[null,"（記載要領）"]
[null,1,"この表は業種（測量・建築コンサルタント・地質調査・補償コンサルタントの５種類ごとに作成してください。"]
[null,2,"建設コンサルタントに会っては、希望業種内容（申請書面上に記載されている詳細を参照）ごとに作成してください。"]
[null,3,"請負代金の額は消費税込みの額を記載してください。"]

{"sheet":"【建設工事】様式6（委任状）","index":4,"n_rows":29,"n_cols":16,"rows_kept":29,"cut":false,"hidden":false,"merged":[[5,1,5,6],[24,6,24,12],[25,6,25,12],[26,6,26,12],[27,6,27,12],[28,6,28,12],[1,1,1,15],[2,5,2,12],[8,7,8,9],[9,7,9,9],[30,4,30,10],[16,3,16,5],[7,5,7,6],[12,1,12,15],[14,0,14,15]],"flags":["formulas_cached_only"]}
["（様式6）"]
[null,"委　　　任　　　状"]
[]
[{"$nulls":10},"令和　　　年　　　月　　　日"]
[]
[null,"青木村長　北村　政夫　様"]
[]
[{"$nulls":5},"委任者",null,"所在地",null,"〒"]
[{"$nulls":7},"商号又は名称"]
[{"$nulls":7},"代表者職氏名",{"$nulls":7},"実印"]
[]
[]
[null,"　私は、令和７・８・９年度の認定期間において、下記の者を代理人と定め下記事項に関する権限を委任します。"]
[]
["記"]
[]
[null,null,null,"受任者",null,null,"所在地",null,"〒"]
[{"$nulls":6},"商号又は名称"]
[{"$nulls":6},"代表者職氏名"]
[{"$nulls":6},"代表者職氏名",{"$nulls":8},"㊞"]
[{"$nulls":6},"電話番号"]
[{"$nulls":6},"ＦＡＸ番号"]
[]
[]
[null,null,"委任する事項",null,null,"１","入札・見積に関すること"]
[{"$nulls":5},"２","契約の締結に関すること"]
[{"$nulls":5},"３","物品の収受に関すること"]
[{"$nulls":5},"４","代金の請求及び受領に関すること"]
[{"$nulls":5},"５","復代理人選任に関すること"]

{"sheet":"営業所一覧","index":5,"n_rows":16,"n_cols":4,"rows_kept":16,"cut":false,"hidden":false,"merged":[[1,0,1,3],[6,0,11,0],[12,0,12,1]],"flags":["formulas_cached_only"]}
[null,"（様式第4）",null,"（用紙Ａ４）"]
["営業所一覧表"]
[]
["区分","営業所名称","所在地","電話番号・FAX番号"]
["本社（社）",null,"〒\n"]
["主たる営業所（委任先）",null,"〒\n"]
["従たる営業所（委任先以外）",null,"〒\n"]
[null,null,"〒\n"]
[null,null,"〒\n"]
[null,null,"〒\n"]
[null,null,"〒\n"]
[null,null,"〒\n"]
["（記載要領）"]
[1,"本店（社）の欄は必ず記入してください。"]
[2,"委任先を設けている場合は、主たる営業所欄に記入してください。"]
[3,"委任先以外の営業所は従たる営業所の欄に記載してください（営業所が多数ある場合は、代表的な営業所のみの記入で構いません）。"]