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[null,"一般競争（指名競争）参加資格審査申請書（建設工事）"]
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[null,null,"令和　　　　　　　年度において、貴  地方整備局   で行われる建設工事に係る競争に参加する資格の審査を申請します。"]
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[null,"※欄については、記載しないこと（以下同じ）。"]

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[{"$nulls":4},"０４",{"$nulls":8},"空港等舗装工事"]
[{"$nulls":4},"０５",{"$nulls":8},"港湾等鋼構造物工事"]
[{"$nulls":4},"そ         の         他"]
[{"$nulls":4},"合                      計"]
["（注）  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。"]

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["※ 受付番号",{"$nulls":45},"※ 業者コ－ド"]
["工     事     分     割     内     訳     表"]
[{"$nulls":247},"（単位 ： 千円）"]
[{"$nulls":9},"競争参加資格希望",{"$nulls":17},"一般土木",{"$nulls":8},"ｱｽﾌｧﾙﾄ\n舗装",{"$nulls":8},"鋼橋上部",{"$nulls":8},"造園",{"$nulls":8},"建築",{"$nulls":8},"木造建築",{"$nulls":8},"電気設備",{"$nulls":8},"暖冷房衛生",{"$nulls":8},"セメント・コンクリート舗装",{"$nulls":8},"プレストレスト・コンクリート",{"$nulls":8},"法面処理",{"$nulls":8},"塗装",{"$nulls":8},"維持修繕",{"$nulls":8},"河川しゅんせつ",{"$nulls":8},"グラウト",{"$nulls":8},"杭打",{"$nulls":8},"さく井",{"$nulls":8},"プレハブ建築",{"$nulls":8},"機械設備",{"$nulls":8},"通信設備",{"$nulls":8},"受変電設備",{"$nulls":8},"橋梁補修",{"$nulls":8},"その他"]
[{"$nulls":19},"工種区分",{"$nulls":215},"※",null,null,"合      計"]
["建設業法上の建設工事"]
["０１",null,null,null,"土木一式",{"$nulls":22},"　",{"$nulls":62},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":17},"　",{"$nulls":89},"　",{"$nulls":8},"　"]
["０２",null,null,null,"建築一式",{"$nulls":58},"　",{"$nulls":8},"　",{"$nulls":35},"　",{"$nulls":71},"　",{"$nulls":53},"　"]
["０３",null,null,null,"大工",{"$nulls":229},"　"]
["０４",null,null,null,"左官",{"$nulls":229},"　"]
["０５",null,null,null,"とび・土工・コンクリ－ト",{"$nulls":40},"　",{"$nulls":44},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":44},"　",{"$nulls":71},"　"]
["０６",null,null,null,"石",{"$nulls":229},"　"]
["０７",null,null,null,"屋根",{"$nulls":229},"　　"]
["０８",null,null,null,"電気",{"$nulls":202},"　",{"$nulls":26},"　"]
["０９",null,null,null,"管",{"$nulls":85},"　",{"$nulls":143},"　"]
["１０",null,null,null,"タイル・れんが・ブロック",{"$nulls":148},"　",{"$nulls":80},"　"]
["１１",null,null,null,"鋼構造物",{"$nulls":40},"　",{"$nulls":71},"　",{"$nulls":116},"　"]
["１２",null,null,null,"鉄筋"]
["１３",null,null,null,"舗装",{"$nulls":31},"　",{"$nulls":62},"　",{"$nulls":35},"　",{"$nulls":98},"　"]
["１４",null,null,null,"しゅんせつ",{"$nulls":229},"　"]
["１５",null,null,null,"板金"]
["１６",null,null,null,"ガラス"]
["１７",null,null,null,"塗装"]
["１８",null,null,null,"防水",{"$nulls":94},"　",{"$nulls":17},"　",{"$nulls":116},"　"]
["１９",null,null,null,"内装仕上"]
["２０",null,null,null,"機械器具設置",{"$nulls":184},"　",{"$nulls":44},"　"]
["２１",null,null,null,"熱絶縁"]
["２２",null,null,null,"電気通信",{"$nulls":112},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":17},"　"]
["２３",null,null,null,"造園"]
["２４",null,null,null,"さく井"]
["２５",null,null,null,"建具"]
["２６",null,null,null,"水道施設",{"$nulls":22},"　",{"$nulls":206},"　"]
["２７",null,null,null,"消防施設"]
["２８",null,null,null,"清掃施設",{"$nulls":58},"　",{"$nulls":170},"　"]
["２９",null,null,null,"解体",{"$nulls":40},"　",{"$nulls":44},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":53},"　",{"$nulls":71},"　"]
["その他",{"$nulls":224},"　",{"$nulls":8},"　"]
[null,"合              計",{"$nulls":25},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　",{"$nulls":8},"　"]
[]
["記載要領"]
[null,"１",null,null,"   本表は、総合評定値通知書に記載されている工事種別ごとの年間平均完成工事高を、当省の定める「競争参加資格希望工種区分」に分割し又は合算して申請する場合に作成すること。"]
[null,"２",null,null,"   「建設業法上の建設工事」の種別には、経営事項審査において審査を受けた全ての建設工事の種別に対応した年間平均完成工事高を記載し、また「競争参加資格希望工種区分」には、"]
[{"$nulls":4},"それに該当する全ての「競争参加資格希望工種区分」を記載すること。"]
[null,"３",null,null,"   「※合計」の欄に記載する数値は、経営事項審査における建設工事の種別ごとの年間平均完成工事高と同一であること。"]
[null,"４",null,null,"　経営事項審査において計上されていない道路清掃作業その他の河川又は道路の維持に関する作業の完成工事高を含めて申請する場合は、「その他」の「維持修繕」の欄に記載すること。"]
[{"$nulls":4},"なお、この欄に記載する場合は、実績が確認できる書類（契約書等の写し）を添付すること。"]

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[]
[null,"※受付番号",{"$nulls":30},"※建設業許可番号"]
[null,"業　態　調　書　（「道路･河川･官庁営繕･公園関係」・「港湾空港関係」  共 通  ）"]
[]
[]
[null,"該当の有無について",{"$nulls":14},"有",{"$nulls":5},"無"]
[null,"資本関係に関する事項"]
[null,"　親会社等（会社法第２条第４号の２の規定によるもの。）・所属する組合"]
[null,1,null,null,"建設業許可番号",{"$nulls":16},"－",{"$nulls":14},"本店電話番号（代表）",{"$nulls":42},"組合を記載した場合",{"$nulls":11},"親会社等",{"$nulls":9},"所属する組合"]
[]
[{"$nulls":4},"更生会社･再生手続中の会社",{"$nulls":20},"商号又は名称"]
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[{"$nulls":4},"本店住所"]
[]
[null,"　親会社等（会社法第２条第４号の２の規定によるもの。）・所属する組合"]
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[]
[{"$nulls":4},"更生会社･再生手続中の会社",{"$nulls":20},"商号又は名称"]
[]
[{"$nulls":4},"本店住所"]
[]
[null,"　子会社等（会社法第２条第３号の２の規定による子会社）"]
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[null,7,{"$nulls":6},"－",{"$nulls":44},17,{"$nulls":6},"－"]
[null,8,{"$nulls":6},"－",{"$nulls":44},18,{"$nulls":6},"－"]
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[{"$nulls":8},"－",{"$nulls":43},"－"]
[{"$nulls":8},"－",{"$nulls":43},"－"]
[{"$nulls":8},"－",{"$nulls":43},"－"]
[]
[null,"役員の兼任に関する事項"]
[{"$nulls":4},"役職名",{"$nulls":11},"氏名",{"$nulls":33},"兼任先の建設業許可番号",{"$nulls":19},"兼任先の商号又は名称（４０文字以内）",{"$nulls":29},"兼任先での役職"]
[null,1,{"$nulls":54},"－"]
[null,2,{"$nulls":54},"－"]
[null,3,{"$nulls":54},"－"]
[null,4,{"$nulls":54},"－"]
[null,5,{"$nulls":54},"－"]
[null,6,{"$nulls":54},"－"]
[null,7,{"$nulls":54},"－"]
[null,8,{"$nulls":54},"－"]
[null,9,{"$nulls":54},"－"]
[null,10,{"$nulls":54},"－"]
[]
[null,"【記載要領】"]
[{"$nulls":4},"１．本調書は、申請日現在で作成すること。"]
[{"$nulls":4},"２．親会社等・所属する組合が建設業許可を受けていない場合には、建設業許可番号欄に「なし」と記載すること。"]
[{"$nulls":4},"３．「親会社等・所属する組合」欄に組合を記載した場合は、当該組合が親会社等の場合には「親会社等」欄にレ点を記入し、所属する組合の場合には「所属する組合」欄にレ点を記入すること。"]
[{"$nulls":4},"４．役職名には、「代表取締役」、「取締役イ」、「取締役ロ」、「取締役ハ」、「取締役ニ」、「取締役ホ」、「執行役」、「業務執行社員」、「理事」、「管財人」、又は「その他」のいずれかを記載する。\n　　「監査役」、「執行役員」等は役員に該当しない。なお、「取締役イ」、「取締役ロ」、「取締役ハ」及び「取締役ニ」は、平成31年4月1日以後に入札手続きを開始する工事においては役員に該当しないが、「取締役イ」、「取締役ロ」、「取\n　　締役ハ」及び「取締役ニ」が兼務する複数の会社等が同一入札へ参加した場合について、当分の間モニタリングを行うため記載の対象とする。「取締役イ」、「取締役ロ」、「取締役ハ」、「取締役ニ」及び「取締役ホ」の内容は下記の通り。\n　　取締役イ：監査等委員会設置会社における監査等委員である取締役\n　　取締役ロ：指名委員会等設置会社における取締役\n　　取締役ハ：社外取締役\n　　取締役ニ：定款に別段の定めがある場合により業務を執行しないこととされている取締役\n　　取締役ホ：上記イからニに掲げる者以外の取締役"]

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[null,"※ 受付番号",{"$nulls":90},"※ 業者コ－ド"]
[null,"業           態           調           書     (｢道路・河川・官庁営繕・公園関係｣その１)"]
[]
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[{"$nulls":35},"薬液注入",{"$nulls":61},216,{"$nulls":62}," その他",{"$nulls":68},145]
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[{"$nulls":35},"建築",{"$nulls":61},221,{"$nulls":62}," その他",{"$nulls":68},147]
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[{"$nulls":35},"仕上げ",{"$nulls":61},223,{"$nulls":62}," 「森林土木」",{"$nulls":68},151]
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[{"$nulls":28},"建設部門に係る選択科目のうち「鋼構造及びコンクリート以外のもの」",{"$nulls":68},41,{"$nulls":62},"実         人         数"]
[{"$nulls":28},"「農業農村工学」",{"$nulls":68},43,{"$nulls":23},1]
[{"$nulls":28},"電気電子部門に係る選択科目",{"$nulls":68},44]
[{"$nulls":28},"「流体機器」又は「熱・動力エネルギー機器」",{"$nulls":68},46]
[{"$nulls":5},"　",{"$nulls":22},"機械部門に係る選択科目のうち「流体機器」又は「熱・動力エネルギー機器」以外のもの",{"$nulls":68},45]
[{"$nulls":5},"総合技術監理部門",{"$nulls":22},"「上水道及び工業用水道」",{"$nulls":68},48]
[{"$nulls":28},"上下水道部門に係る選択科目のうち「上水道及び工業用水道」以外のもの",{"$nulls":68},47,{"$nulls":62},"監理技術者資格者証及び監理技術者講習修了証の\n所　　　持　　　者　　　数"]
[{"$nulls":28},"「林業・林産」",{"$nulls":68},50]
[{"$nulls":28},"「森林土木」",{"$nulls":68},51,{"$nulls":62},"登録基幹技能者講習修了証の　　所　持　者　数"]
[{"$nulls":28},"「水質管理」",{"$nulls":68},53]
[{"$nulls":28},"「廃棄物・資源循環」",{"$nulls":68},54]
[{"$nulls":28},"衛生工学に係る選択科目のうち「水質管理」、「廃棄物・資源循環」以外のもの",{"$nulls":68},52]
[]
[null,"記載要領"]
[null,"※",null,null,"｢有資格技術者職員内訳｣の人数欄については、申請時点で在籍している有資格技術職員"]
[{"$nulls":4},"の資格の内訳について記載すること。"]
[null,"※",null,null,"また、｢監理技術者資格者証及び監理技術者講習修了証の所持者数｣については、同技術者名簿<別紙二>の｢資格者証交付番号｣欄に同交付番号が記載"]
[{"$nulls":4},"されている技術者で監理技術者講習修了証を所持している技術者を集計し､合計人数を記入すること。"]
[{"$nulls":5},"※",null,"平成２８年４月１日以後に監理技術者資格者証の交付を受けているもの。"]
[null,"※",null,null,"「登録基幹技能者講習修了証の所持者数」欄については、建設業施行規則第１８条の３第２項第２号に規定する登録基幹技能講習を修了した者であって、"]
[{"$nulls":4},"雇用期間を特に限定することなく常時雇用されている者を記入すること。 "]

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[]
["※ 受付番号",{"$nulls":45},"※ 業者コ－ド"]
["業           態           調           書     (｢道路・河川・官庁営繕・公園関係｣その２)"]
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[]
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["設備工事比率  （％）",{"$nulls":133},"Ｄ",null,"砂防・地すべり防止",{"$nulls":15},"Ｄ",null,"道路清掃\n作業"]
[{"$nulls":25},"暖冷房衛生設備工事における暖冷房設備工事の比率",{"$nulls":108},"Ｅ",null,"トンネル",{"$nulls":15},"Ｅ",null,"その他の補修"]
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[{"$nulls":134},"Ｇ",null,"軟弱地盤",{"$nulls":15},"Ｂ",null,"場所打ち\nコンクリ－ト杭"]
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[{"$nulls":129},"ﾌﾟﾚｽﾄ ﾚｽﾄ・ｺ ﾝｸﾘ-ﾄ",{"$nulls":4},"Ａ",null,"プレテンション",{"$nulls":15},"Ｄ",null,"ダム施工\n機械設備"]
["東北",{"$nulls":133},"Ｂ",null,"ポストテンション",{"$nulls":15},"Ｅ",null,"昇降機設備"]
["関東",{"$nulls":128},"法面\n処理",{"$nulls":4},"Ａ",null,"アンカ－工",{"$nulls":15},"Ｆ",null,"消・融雪設備"]
["北陸",{"$nulls":133},"Ｂ",null,"その他",{"$nulls":15},"Ｇ",null,"その他"]
["中部",{"$nulls":128},"塗装",{"$nulls":4},"Ａ",null,"建物塗装",{"$nulls":10},"通信\n設備",{"$nulls":4},"Ａ",null,"監視制御・\n情報通信設備"]
["近畿",{"$nulls":133},"Ｂ",null,"橋梁塗装・\n水門扉塗装",{"$nulls":15},"Ｂ",null,"防災・情報\n表示設備"]
["中国",{"$nulls":133},"Ｃ",null,"区画線",{"$nulls":15},"Ｃ",null,"有線通信線路"]
["四国",{"$nulls":133},"Ｄ",null,"その他",{"$nulls":15},"Ｄ",null,"鉄塔・反射板"]
["九州",{"$nulls":146},"受変電\n設備",{"$nulls":4},"Ａ",null,"受変電設備"]
[{"$nulls":152},"Ｂ",null,"発電設備"]
[{"$nulls":152},"Ｃ",null,"その他の\n電源設備"]
[]
["記載要領"]
["１",null,null,null,"   「希望する工事の内容」については、希望する工事の内容に対応するコ－ドを希望する順位の順番に記載すること。"]
[{"$nulls":4},"   様式①－２において希望した工事種別のみ記入すること。"]
["２",null,null,null,"   申請後の希望順位の変更、追加、削除はできません。"]

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[]
[null,"※受付番号",{"$nulls":26},"※業者コード"]
[null,"業　　　態　　　調　　　書（「港湾空港関係」）"]
[null,null,"港湾工事用作業船保有状況"]
[{"$nulls":7},"区　　　　　　　分",{"$nulls":33},"能　力",{"$nulls":10},"単　　位",{"$nulls":14},"単位総数"]
[{"$nulls":67},"自社保有船舶",{"$nulls":17},"共有船舶",{"$nulls":17},"借上船舶",{"$nulls":17},"合　　計"]
[{"$nulls":7},1,null,null,"浚渫船",{"$nulls":30},"掘削力",{"$nulls":10},"ｍ3／ｈ"]
[{"$nulls":52},"（浚渫能力）"]
[{"$nulls":7},2,null,null,"揚土船",{"$nulls":30},"揚土力",{"$nulls":10},"ｍ3／ｈ"]
[{"$nulls":52},"（揚土能力）"]
[{"$nulls":7},3,null,null,"起重機船（15t吊以上）",{"$nulls":30},"築造力",{"$nulls":10},"ｔ"]
[{"$nulls":52},"（吊荷重）"]
[{"$nulls":7},4,null,null,"杭打船",{"$nulls":30},"杭打力",{"$nulls":10},"ＰＳ"]
[{"$nulls":52},"（主機馬力）"]
[{"$nulls":7},5,null,null,"ケーソン製作用作業台船",{"$nulls":30},"製作力",{"$nulls":10},"ｔ"]
[{"$nulls":52},"（揚荷能力）"]
[{"$nulls":7},6,null,null,"地盤改良船",{"$nulls":30},"地　盤",{"$nulls":10},"隻数"]
[{"$nulls":41},"改良力"]
[{"$nulls":7},7,null,null,"砕岩船",{"$nulls":30},"砕岩力",{"$nulls":10},"隻数"]
[]
[{"$nulls":7},8,null,null,"その他特殊船",{"$nulls":30},"－",{"$nulls":10},"隻数"]
[]
[{"$nulls":7},9,null,null,"環境性能の高い作業船",{"$nulls":30},"－",{"$nulls":10},"隻数"]
[]
[null,"（注）"]
[null,null,null,"１．揚土船には、リクレーマ船、バージアンローダー船、圧送船を含む。"]
[null,null,null,"２．起重機船には、クレーン付台船を含む｡"]
[null,null,null,"３．地盤改良船には、固化材プラント船を含む｡"]
[null,null,null,"４．砕岩船には、砕岩専用船を記入する。（グラブ浚渫船等との兼用船は含まない）"]
[null,null,null,"５．その他特殊船は、砂撒船、トレミー船、コンクリートミキサー船とする。"]
[null,null,null,"６．環境性能の高い作業船とは、「海洋汚染等及び海上災害の防止に関する法律」に定める、窒素酸化物の放出量に係る放出基準を満足する作業船を指す。"]
[{"$nulls":5},"対象とする作業船は、区分１～８に示す作業船と同じとし、該当する場合は重複して記載することとする。"]
[null,null,null,"７．記載事項の基準日は定期の資格審査を行う直前の12月１日とする｡"]
[]
[null,null,"専門技術者状況"]
[null,26,{"$nulls":5},"登録海上起重基幹技能者　※１",{"$nulls":44},"人"]
[]
[{"$nulls":7},"海上起重作業管理技士　※２",{"$nulls":44},"人"]
[]
[null,null,"一般社団法人日本海上起重技術協会の行う「登録海上起重基幹技能者」又は「海上起重作業管理技士」の認定試験に合格し登録を受けている者の人数を記載する｡"]
[null,null,"※１　「登録海上起重基幹技能者」のみの登録、又は「登録海上起重基幹技能者」及び「海上起重作業管理技士」の両方の登録を受けている者の人数を記入する。"]
[null,null,"※２　「海上起重作業管理技士」のみの登録を受けている者の人数を記入する。（「登録海上起重基幹技能者」と重複して計上しない。）"]
[null,null,"なお、「登録海上起重基幹技能者」及び「海上起重作業管理技士」の両方の登録を受けている者がいる場合は、重複して人数を記入しないこと。\nまた、記載事項の基準日は定期の資格審査を行う直前の10月1日とする。"]

{"sheet":"③-5業態調書","index":8,"n_rows":42,"n_cols":41,"rows_kept":42,"cut":false,"hidden":false,"merged":[[27,0,28,0],[32,0,33,0],[0,0,0,2],[0,14,0,19],[1,0,1,44],[12,0,13,0],[17,0,18,0],[22,0,23,0],[0,3,0,12],[0,20,0,27],[13,1,13,12],[13,14,13,28],[13,32,13,33],[13,35,13,36],[13,38,13,39],[18,32,18,33],[18,35,18,36],[18,38,18,39],[15,13,15,42],[23,32,23,33],[23,35,23,36],[23,38,23,39],[28,32,28,33],[28,35,28,36],[28,38,28,39],[33,32,33,33],[33,35,33,36],[33,38,33,39],[35,3,35,4],[35,6,35,7],[35,9,35,10],[35,13,35,42],[30,3,30,4],[30,6,30,7],[30,9,30,10],[25,3,25,4],[25,6,25,7],[25,9,25,10],[20,3,20,4],[20,6,20,7],[20,9,20,10],[15,3,15,4],[15,6,15,7],[15,9,15,10],[18,1,18,12],[23,1,23,12],[28,1,28,12],[33,1,33,12],[18,14,18,28],[23,14,23,28],[28,14,28,28],[33,14,33,28],[20,13,20,42],[25,13,25,42],[30,13,30,42]],"flags":["formulas_cached_only"]}
["※受付番号",{"$nulls":13},"※建設業許可番号"]
["業　態　調　書　（「道路･河川･官庁営繕･公園関係」・「港湾空港関係」  共 通  ）"]
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[]
["国土交通省退職者の再就職状況に関する事項"]
[1,"平成17年10月1日以降に営業担当部署に就いた者の氏名",{"$nulls":12},"平成17年10月1日以降における役職",{"$nulls":15},"営業担当部署への就任年月日（必ず平成17年10月1日以降の日付）"]
[{"$nulls":30},"平成\n令和",null,null,null,"年",null,null,"月",null,null,"日"]
[null,"国土交通省における退職日",{"$nulls":11},"国土交通省における退職時の官職"]
[null,"平成\n令和",null,null,null,"年",null,null,"月",null,null,"日"]
[]
[2,"平成17年10月1日以降に営業担当部署に就いた者の氏名",{"$nulls":12},"平成17年10月1日以降における役職",{"$nulls":15},"営業担当部署への就任年月日（必ず平成17年10月1日以降の日付）"]
[{"$nulls":30},"平成\n令和",null,null,null,"年",null,null,"月",null,null,"日"]
[null,"国土交通省における退職日",{"$nulls":11},"国土交通省における退職時の官職"]
[null,"平成\n令和",null,null,null,"年",null,null,"月",null,null,"日"]
[]
[3,"平成17年10月1日以降に営業担当部署に就いた者の氏名",{"$nulls":12},"平成17年10月1日以降における役職",{"$nulls":15},"営業担当部署への就任年月日（必ず平成17年10月1日以降の日付）"]
[{"$nulls":30},"平成\n令和",null,null,null,"年",null,null,"月",null,null,"日"]
[null,"国土交通省における退職日",{"$nulls":11},"国土交通省における退職時の官職"]
[null,"平成\n令和",null,null,null,"年",null,null,"月",null,null,"日"]
[]
[4,"平成17年10月1日以降に営業担当部署に就いた者の氏名",{"$nulls":12},"平成17年10月1日以降における役職",{"$nulls":15},"営業担当部署への就任年月日（必ず平成17年10月1日以降の日付）"]
[{"$nulls":30},"平成\n令和",null,null,null,"年",null,null,"月",null,null,"日"]
[null,"国土交通省における退職日",{"$nulls":11},"国土交通省における退職時の官職"]
[null,"平成\n令和",null,null,null,"年",null,null,"月",null,null,"日"]
[]
[5,"平成17年10月1日以降に営業担当部署に就いた者の氏名",{"$nulls":12},"平成17年10月1日以降における役職",{"$nulls":15},"営業担当部署への就任年月日（必ず平成17年10月1日以降の日付）"]
[{"$nulls":30},"平成\n令和",null,null,null,"年",null,null,"月",null,null,"日"]
[null,"国土交通省における退職日",{"$nulls":11},"国土交通省における退職時の官職"]
[null,"平成\n令和",null,null,null,"年",null,null,"月",null,null,"日"]
[]
["【記載要領】"]
[null,"１．本調書は、申請日現在で作成すること。"]
[null,"２．社内異動及び新規採用は問わず、平成17年10月1日以降に営業担当部署に就いた者を対象とする。（平成17年10月1日以前から営業担当部署に就いている者は対象としない。）"]
[null,"３．「国土交通省における退職時の官職」欄はできるだけ詳しく記入する。ただし、「国土交通省」は記入しない。（例：○○地方整備局○○河川国道事務所○○課長）"]
[null,"４．「国土交通省における退職時の官職」及び「国土交通省における退職日」は把握している範囲において記入すること。"]

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["※ 受付番号",{"$nulls":45},"※ 業者コ－ド"]
["営          業          所          一          覧          表"]
[]
[{"$nulls":87},"電 話 番 号  （上段）",{"$nulls":25},"建     設     業     許     可     業     種 ",{"$nulls":50}," （  上  段  ）"]
["番",null,null,null,"営    業    所    名    称",{"$nulls":27},"郵  便",{"$nulls":8},"所            在            地",{"$nulls":69},"土",null,"建",null,"大",null,"左",null,"と",null,"石",null,"屋",null,"電",null,"管",null,"タ",null,"鋼",null,"筋",null,"舗",null,"しゅ",null,"板",null,"ガ",null,"塗",null,"防",null,"内",null,"機",null,"絶",null,"通",null,"園",null,"井",null,"具",null,"水",null,"消",null,"清",null,"解"]
["号",{"$nulls":31},"番  号",{"$nulls":54},"F A X 番 号  （下段）",{"$nulls":25},"営             業             区             域",{"$nulls":41},"（  下  段  ）"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
[{"$nulls":37},"-"]
[]
["記載要領"]
[null,"１",null,null,"本表は、申請日時点において作成すること。"]
[null,"２",null,null,"「営業所名称」欄には、経営事項審査を受けた建設業の許可を有する全ての本店又は支店等営業所の名称を記載すること。"]
[null,"３",null,null,"「電話番号」欄及び「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。この場合においては、市外局番、市内局番及び番号を、「－（ハイフン）」で区切り記載すること。"]
[null,"４",null,null,"「建設業許可業種（上段）」の欄には、「営業所名称」欄に記入した営業所に対応する経営事項審査を受けた建設業許可業種の欄に○印を付すこと。"]
[null,"５",null,null,"「営業区域（下段）」の欄には、その営業所が営業する区域について、該当するコ－ドを記載すること。ただし、道路･河川･官庁営繕･公園関係のみを希望する場合は、「営業区域」の欄への"]
[{"$nulls":4},"記載は要しないこと。"]

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