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y pUTit <br />CITY OF SOUTH BEND INDIANA �• X > , <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />11165 <br />CHECKLIST FOR BIDDERS <br />Project Name Fellows Streetscape <br />Project No. 116-041B <br />For Bids Due June 27, 2017 <br />From time to time the South Bend Board of Public Works finds it necessary to reject a bid because <br />it does not comply with statutory requirements. In preparing your bid, please use the following <br />checklist in order 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 />X or Bid Bond. <br />Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely <br />X executed, <br />Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding investments <br />with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and <br />X Certification of use of United States Steel Products or Foundry Products. <br />Proof of MBF_IWBE Participation Coal Form [MWBE-1.01. It minimum participation goal Is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2,0] and MBEIWIBE Contacted <br />X Form [MWBE-2.1], <br />X Acknowledge Receipt of #1 Addendum(s) included with the bid. <br />X 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 />X printed or typed underneath signature. <br />X This checklist submitted with the Bid, <br />This checklist is provided for bidder's use in assuring compliance with required <br />documentation; however, It does not include all specifications requirements and does not <br />relieve the bidder of the need to read and comply with the specifications. <br />Bidder: Rieth-Riley Construction Co., Inc. Date: June 27, 2017 <br />By Authorized Representative: <br />Signature: <br />Print Name & Title: Joshua A,. lbCormick, Sales Manager <br />Version 10117/2016 Contractor's Bid for Public Works - i Addendum 1 <br />