Opening of Bids - Ironwood Dr. Pavement Rehabiliation Proj No 117-071A - Selge Construction Co., Inc

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OU T;J CITY OF SOUTH BEND, INDIANA CONTRACTOR'S BID FOR PUBLIC WORK M65 CHECKLIST FOR BIDDERS Project Name Ironwood Drive Pavement Rehabilitation and Intersection Project No. 117'-O71A For Bids Due February 27, 2018 From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does not comply with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your bid is done in the proper manner. Proper bid security included. The bidder has the option of providing either a Certified Check X or Bid Bond. X Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely executed. Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments X with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and Certification of use of United States Steel Products or Foundry Products. Proof of MBE/WBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not X met, also provide Evidence of Good Faith Efforts Form [MWBE-2,01 and MBE/WBE Contacted — Form [MWBE-2.1]. X Acknowledge Receipt of I Addendum(s) included with the bid. X All required additional information is included with the bid. Proposal statements and other affidavits all signed by the proper party with name either X printed or typed underneath signature. X This checklist submitted with the Bid. This checklist is provided for bidder's use in assuring compliance with required documentation; however, it does not include all specifications requirements and does not relieve the bidder of the need to read and comply with the specifications. Bidder: Selge Construction Co., Inc. By Authorized Representative,--, Signature: Print Narne& Title: Robert Kuhns, Project Engineer Version 10/17/2017 Contractor's Bid for Public Works - 1 Date: 2/27/18