Quote Opening - Ireland Road Storm Repairs Proj No. 116-083G - Walsh&Kelly

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State Form 52414 (R / 910) Prescribed by State Board of Accounts Form No 96 (Revised 2010) CONTRACTOR'S BID FOR PUBLIC WORK — FORM 96 PART 1 (To be completed for all bids. Please type or print) Date (month, day, year): October 20, 2016 1. Governmental Unit (Owner): Department of Public Works. City of South Bend 2. County: St Joseph 3. Bidder (Firm): Address: City/State: 4. Telephone Number: 5. Agent of Bidder (If applicable): Walsh & Kelly, Inc. 24358 State Road 23 South Bend IN 46614 574-288-4811 Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public works project of Ireland Rd at High St 116-083G (Governmental Unit) in accordance with plans and specifications prepared by Brian M Smith PE and dated 10-12-16 for the sum of See Attached $ See Attached The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any addendums attached will be specifically referenced at the applicable page. If additional units of material included in the contract are needed, the cost of units must be the same as that shown in the original contract if accepted by the Governmental Unit. If the bid is to be awarded on a unit basis, the itemization of the units shall be shown on a separate attachment. The Contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee, or applicant for employment, to be employed in the performance of this contract, with respect to any matter directly or indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this covenant may be regarded as a material breach of the contract. CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS (If applicable) 1, the undersigned bidder or agent as a contractor on a public works project, understand my statutory obligation to use steel products made in the United States. I.C. 5-16-8-2. I hereby certify I and all subcontractors employed by me for this project will use U.S. steel products on this project if awarded. I understand that violations hereunder may result in forfeiture of contractual payments.