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["様式１－１"]
[]
["01",null,"１：新規",{"$nulls":4},"※02 受付番号",{"$nulls":65},"※03 業者コード",{"$nulls":87},"※",{"$nulls":4},"申請者",{"$nulls":23},"05",{"$nulls":4},"適格組",{"$nulls":13},"平成　　年　　月　　日"]
[null,null,"２：更新",{"$nulls":158},"04",{"$nulls":4},"の規模",{"$nulls":28},"合証明",{"$nulls":13},"第　　　　　　　　　号"]
[]
["一般競争（指名競争）参加資格審査申請書（測量・建設コンサルタント等）"]
[]
[null,"平成28・29年度において、貴村で行われる測量・建設コンサルタント等業務に係る競争に参加する資格の審査を申請します。"]
[null,"なお、この申請書及び添付書類の内容については、事実と相違しないことを誓約します。"]
[]
[null,null,"平成　　　　年　　　　月　　　　日"]
[]
[{"$nulls":4},"天　川　村　長　　殿"]
[]
["06",null,null,"本社(店)郵便番号",{"$nulls":23},"－"]
[]
[]
[null,null,null,"フリガナ"]
[]
["07",null,null,"本社(店)住所"]
[]
[]
[null,null,null,"フリガナ"]
[]
["08",null,null,"商号又は名称"]
[]
[]
["09",null,null,"役職"]
[]
[]
[null,null,null,"フリガナ",{"$nulls":138},"フリガナ"]
[]
[null,null,null,"代表者氏名",{"$nulls":93},"㊞",{"$nulls":37},10,{"$nulls":6},"担当者氏名"]
[]
[]
["11",null,null,"本社(店)電話番号",{"$nulls":131},12,{"$nulls":6},"担当者電話番号"]
[]
[{"$nulls":192},"（内線番号",{"$nulls":54},"）"]
[]
["13",null,null,"本社(店)FAX番号",{"$nulls":97},14,{"$nulls":6},"メールアドレス"]
[]
[]
["15",null,null,"登録を受けている事業"]
[]
[{"$nulls":4},"登 録 事 業 名",{"$nulls":7},"登 録 番 号",{"$nulls":27},"登 録 年 月 日",{"$nulls":31},"登 録 事 業 名",{"$nulls":32},"登 録 番 号",{"$nulls":27},"登 録 年 月 日",{"$nulls":29},"登 録 事 業 名",{"$nulls":31},"登 録 番 号",{"$nulls":28},"登 録 年 月 日"]
[{"$nulls":4},"測量業者",{"$nulls":7},"第　　　　　号",{"$nulls":27},"   年   月   日",{"$nulls":31},"建築士事務所",{"$nulls":32},"第　　　　　号",{"$nulls":27},"   年   月   日",{"$nulls":29},"建設コンサルタント",{"$nulls":31},"第　　　　　号",{"$nulls":28},"   年   月   日"]
[{"$nulls":4},"地質調査業者",{"$nulls":7},"第　　　　　号",{"$nulls":27},"   年   月   日",{"$nulls":31},"補償コンサルタント",{"$nulls":32},"第　　　　　号",{"$nulls":27},"   年   月   日",{"$nulls":29},"不動産鑑定業者",{"$nulls":31},"第　　　　　号",{"$nulls":28},"   年   月   日"]
[{"$nulls":4},"土地家屋調査士",{"$nulls":7},"第　　　　　号",{"$nulls":27},"   年   月   日",{"$nulls":31},"司法書士",{"$nulls":32},"第　　　　　号",{"$nulls":27},"   年   月   日",{"$nulls":29},"計量証明事業者",{"$nulls":31},"第　　　　　号",{"$nulls":28},"   年   月   日"]
[{"$nulls":12},"第　　　　　号",{"$nulls":27},"   年   月   日",{"$nulls":64},"第　　　　　号",{"$nulls":27},"   年   月   日",{"$nulls":61},"第　　　　　号",{"$nulls":28},"   年   月   日"]
[null,"※欄については、記入しないこと（以下同じ）。"]

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["様式１－２"]
[]
["※ 受付番号",{"$nulls":56},"※ 業者コード"]
[]
[16,{"$nulls":4},"測量等実績高"]
[]
[{"$nulls":33},"② 直 前 2 年 度 分 決 算",{"$nulls":35},"② 直 前 1 年 度 分 決 算"]
[null,"①　競　争　参　加　資　格",{"$nulls":31}," 　年 　月から",{"$nulls":17}," 　年 　月から",{"$nulls":17}," 　年 　月から",{"$nulls":17}," 　年 　月から",{"$nulls":17},"④　直　前　２　ヶ　年　間　の"]
[null,"　　希　望　業　種　区　分",{"$nulls":31}," 　年 　月まで",{"$nulls":17}," 　年 　月まで",{"$nulls":17}," 　年 　月まで",{"$nulls":17}," 　年 　月まで",{"$nulls":17},"　　年　間　平　均　実　績　高"]
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["様式１－３"]
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[25,{"$nulls":4},"常　勤　職　員　の　数",{"$nulls":23},"①　技　術　職　員",{"$nulls":23},"②　事　務　職　員",{"$nulls":23},"③　そ の 他 の 職 員",{"$nulls":23},"④　　計　　　",{"$nulls":23},"⑤役職員等"]
[{"$nulls":5},"（人）　",{"$nulls":133},"※　⑤は④の内数"]

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[{"$nulls":4},"※受付番号",{"$nulls":17},"※受付コード"]
[]
["営　　業　　所　　一　　覧　　表"]
[]
["番　号","営 業 所 名 称",{"$nulls":11},"郵 便\n\n番 号",null,null,null,"所　　　　　　　　在　　　　　　　　地",{"$nulls":33},"電話・FAX番号"]
[{"$nulls":16},"-"]
[]
[{"$nulls":16},"-"]
[]
[{"$nulls":16},"-"]
[]
[{"$nulls":16},"-"]
[]
[{"$nulls":16},"-"]
[]
[{"$nulls":16},"-"]
[]
[{"$nulls":16},"-"]
[]
[{"$nulls":16},"-"]
[]
[{"$nulls":16},"-"]
[]
[{"$nulls":16},"-"]
[]
[]
["記載要領"]
[null,"１　本表は、申請日現在で作成すること。"]
[null,"２　「営業所名称」欄には、常時契約を締結するすべての本店又は支店等営業所の名称を記載すること。"]
[null,"３　「所在地」欄には、営業所の所在地を上段から左詰めで記載すること。"]
[null,"４　「電話・ＦＡＸ番号」欄には、上段に電話番号を、下段にＦＡＸ番号を記載することとし、市外局番、市内局番及び番号は、「－（ハイフン）」で区切ること。"]

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["様式2"]
[]
[null,null,"業態調書（測量・建設コンサルタント等）"]
[]
[]
["測量調査設計業務実績サービス（ＴＥＣＲＩＳ）における会社コード"]
[]
[]
[]
[]
["登録部門及び希望業務の確認"]
[]
[null,"登録部門及び希望業務","測量",null,null,"建築関係建設コンサルタント業務",{"$nulls":14},"土木関係建設コンサルタント業務",{"$nulls":29},"　地　　質　　調　　査","補償関係コンサルタント業務"]
[null,null,"　測量一般","　地図の調整","　航空測量","　建築一般","　意匠","　構造","　暖冷房","　衛生","　電気","　建築積算","　機械積算","　電気積算","　工事監理（建築）","　工事監理（電気）","　工事監理（機械）","　調査","　耐震診断","　地区計画及び地域計画","建設コンサルタント",{"$nulls":20},"　交通量調査","　環境調査","　経済調査","　分析・解析","　宅地造成","　電算関係","　計算業務","　資料等整理","　施工管理",null,"補償コンサルタント",{"$nulls":6},"　不動産鑑定","　登記手続等"]
[{"$nulls":20},"　河川・砂防及び海岸・海洋","　港湾及び空港","　電力土木","　道路","　鉄道","　上水道及び工業用水","　下水道","　農林土木","　森林土木","　水産土木","　廃棄物","　造園","　都市計画及び地方計画","　地質","　土質及び基礎","　鋼構造及びコンクリート","　トンネル","　施工計画・施工設備及び積算","　建設環境","　機械","　電気電子",{"$nulls":10},"　土地調査","　土地評価","　物件","　機械工作物","　営業補償・特殊補償","　事業損失","　補償関連"]
[null,"登録"]
[]
[null,"希望"]
[]
[null,"記載要領"]
[null,"1　「測量業務」における「測量一般」、「地図の調整」及び「航空測量」を希望される方は、測量法第55条の登録がなければ希望することはできません。"]
[null,"2　「建築関係建設コンサルタント業務」における「建築一般」を希望される方は、建築士法第23条の登録がなければ希望することはできません。"]
[null,"3　「補償関係コンサルタント」における「不動産鑑定」を希望される方は、不動産の鑑定評価に関する法律第22条による登録がなければ希望することはできません。"]
[null,"4　工事監理（建築）、工事監理（電気）及び工事監理（機械）については、自社の設計した事案以外の工事監理業務についても希望する場合は、記載してください。"]

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["様式４"]
[]
["※ 受付番号",{"$nulls":56},"※ 業者コード"]
[]
[{"$nulls":45},"技　 術　 者　 経　 歴　 書"]
[]
["（種類）"]
[]
["氏　　　　名",{"$nulls":18},"最　　終　　学　　歴",{"$nulls":29},"法　 令　 に　 よ　 る　 免　 許　 等",{"$nulls":47},"実　　　務　　　経　　　歴",{"$nulls":44},"経 験 年 数"]
[{"$nulls":19},"学　校　名",{"$nulls":14},"学　　　科"]
[{"$nulls":142},"　　年　　月"]
[]
[]
[{"$nulls":142},"　　年　　月"]
[]
[]
[{"$nulls":142},"　　年　　月"]
[]
[]
[{"$nulls":142},"　　年　　月"]
[]
[]
[{"$nulls":142},"　　年　　月"]
[]
[]
[{"$nulls":142},"　　年　　月"]
[]
[]
[{"$nulls":142},"　　年　　月"]
[]
[]
[{"$nulls":142},"　　年　　月"]
[]
[]
[{"$nulls":142},"　　年　　月"]
[]
[]
[{"$nulls":142},"　　年　　月"]
[]
[]
[]
["記載要領"]
[null,null,"１　本表は、土木、建築若しくは設備又は職種の各別に作成すること。"]
[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を締結する事務所）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,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,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,null,"　　（例：○○建築士、○○土木施工管理技士）"]
[null,null,"４　「実務経歴」の欄には、最近のものから記載し、純粋に測量、建設コンサルタント等業務に従事した職種及び地位を記載すること。"]

{"sheet":"委任状","index":6,"n_rows":33,"n_cols":27,"rows_kept":33,"cut":false,"hidden":false,"merged":[[21,6,21,9],[21,2,21,5],[22,6,22,9],[32,2,32,5],[27,2,28,5],[23,6,23,9],[24,6,24,9],[11,11,11,14],[14,1,14,27],[20,6,20,9],[1,4,1,23],[9,11,9,14],[10,11,10,14],[10,7,10,10]],"flags":["formulas_cached_only"]}
[]
[{"$nulls":4},"委　　任　　状"]
[]
[]
[]
[{"$nulls":26},"平成　　年　　月　　日"]
[]
[null,null,"天　川　村　長　　殿"]
[]
[{"$nulls":11},"住所"]
[{"$nulls":7},"（委任者）",null,null,null,"商号又は名称"]
[{"$nulls":11},"氏名",{"$nulls":13},"印"]
[]
[]
[null,"　下記の者を代理人と定め、天川村との間に行う契約について次の権限を委任します。"]
[]
[]
[{"$nulls":14},"記"]
[]
[]
[{"$nulls":6},"住所"]
[null,null,"（受任者）",null,null,null,"商号又は名称"]
[{"$nulls":6},"氏名",{"$nulls":18},"印"]
[{"$nulls":6},"電話番号"]
[{"$nulls":6},"ＦＡＸ番号"]
[]
[{"$nulls":6},"１　入札及び見積に関する一切の権限"]
[null,null,"（委任事項）",null,null,null,"２　復代理人選定に関する一切の権限"]
[{"$nulls":6},"３　契約の締結及び契約の履行に関する一切の権限"]
[{"$nulls":6},"４　代金の請求及び受領に関する一切の権限"]
[]
[]
[null,null,"（委任期間）",null,null,null,"平成　　年　　月　　日　から",{"$nulls":9},"平成　　年　　月　　日　まで"]

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[{"$nulls":10},"使　用　印　鑑　届"]
[]
[]
[]
[{"$nulls":10},"使用印",{"$nulls":14},"実印"]
[]
[]
[]
[null,null,"上記の印鑑は、入札見積に参加し、契約の締結並びに代金の請求受領のために使用したいのでお届けします。"]
[]
[{"$nulls":8},"平成　　　年　　　月　　　日"]
[]
[{"$nulls":17},"住所"]
[{"$nulls":17},"商号又は名称"]
[{"$nulls":17},"代表者",{"$nulls":22},"印"]

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["様式３"]
[]
["※ 受付番号",{"$nulls":56},"※ 業者コード"]
[]
[{"$nulls":45},"測　量　等　実　績　調　書"]
[]
["（登録業種区分）"]
[]
["発　注　者",{"$nulls":12},"元請又は\n下請の別",{"$nulls":10},"件　　　　　　　　　　　　名",{"$nulls":48},"測 量 等 対 象 の 規 模 等",{"$nulls":33},"業務履行場所の\nある都道府県名",{"$nulls":15},"請負代金の\n額（千円）",{"$nulls":11},"着手年月",{"$nulls":11},"完成年月\n（予 定）"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":24},"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        v",{"$nulls":110},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[{"$nulls":135},"　年　月",{"$nulls":11},"　年　月"]
[]
["記載要領"]
[null,null,"１　本表は、登録を受けた業種の各別又はその他の営業の種類の各別に作成すること。"]
[null,null,"２　本表は、直前２年間の主な完成業務及び直前２年間に着手した主な未完成業務について記載すること。"]
[null,null,"３　下請については、「注文者」の欄には元請業者名を記載し、「件名」の欄には下請件名を記載すること。"]
[null,null,"４　「測量等対象の規模等」の欄には、例えば測量の面積・精度等、設計の階数・構造・延べ面積等を記載すること。"]
[null,null,"５　「請負代金の額」は、消費税込みの金額を記載すること。"]