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0 0 1bII <br />Me IZ 1111 M —11" to] LiM M lei <br />067:4113191MMEM <br />Project Name Ironwood: Drive Pavement Rehabilitation and Intersection <br />Project No. 117-071A <br />For Bids Due February 27, 2018 <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 />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 MBE/WBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2,0] and MBENVBE Contacted <br />X Foirm [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 />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 />3� MT M".1 231 <br />By Authorized Rep <br />Signature: <br />Print Name & Title: Lynn J <br />r, South Bend ODerations Ma <br />Vers,ion 10/17/2017 Contractor's Bid for Public Works - 1 <br />2/27/18 <br />% -. . <br />e r <br />Z, <br />