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.pUxft'.':'. <br />0 <br />F j <br />CITY OF SOUTH BEND, INDIANA <br />6 i. <br />Contractor's Bid for Public Work t8b <br />CHECKLIST FOR BIDDERS <br />Project Name Newman Center: Masonry Repair <br />Project No. 116-132 <br />For Bids Due 9:30 am, January 10, 2017 <br />From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does <br />not comply with statutory requirements. In preparing your bid, please use the following checklist in order <br />to make sure that your bid is done in the proper manner. <br />Proper bid security included. The bidder has the option of providing either a Certified Check <br />or Bid Bond. <br />Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely <br />executed. <br />Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments <br />with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and <br />_✓ Certification of use of United States Steel Products or Foundry Products. <br />Proof of MBEMBE Participation Goal Form [MWBE-1.0j. If minimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted <br />Form [MWBE-2.1]. <br />Acknowledge Receipt of Addendum(s) included with the bid. <br />All required additional information is included with the bid. <br />Proposal statements and other affidavits all signed by the proper party with name either <br />printed or typed underneath signature. <br />/ This checklist submitted with the Bid. <br />This checklist is provided for bidder's use in assuring compliance with required documentation; <br />however, it does not include all specifications requirements and does not relieve the bidder of the <br />need to read and comply with the specifications. <br />Bidder: Date: t �tMI ZU' 7 <br />By Authorized Representative: <br />Signature: <br />Print Name & Title: `2> t �' �'— V+ e? % o vLe_ Jkees., e.w} <br />Version 10/17/2016 Contractor's Bid for Public Works <br />