Opening of Bids - Downtown South Bend Cross Streets Improvements Phase I Proj No 117-041A - Walsh & Kelly, Inc - Financials Included, Not Scanned

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a" -.3 M AJO Mill :141 TIT CHECKLIST FOR BIDDERS Project Name Downtown South Bend Cross Streets, Phase 1 Project No. For Bids Due 117-041A April 10, 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 its done in the proper manner. Proper bid security included. The bidder has the option of providing either, a Certified Check or Bid Bond. Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely X executed. Contractor's Non-Collusilon and Non -Debarment Affidavit, Certification Regarding Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and X Certification of use of United States Steel Products or Foundry Products, Proof of MBEIWBE Participation Goal Form [MWBE-1.0]. if minimum participation goal is not X met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBEMBE Contacted Form [MWBE-2.1]. X Acknowledge Receipt of 1 & 2 Addeindum(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 printed or typed! underneath signature. 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: Walsh & Kelly, Inc. By Authorized Re,preseptake: Signature: Print Name & 0 M. Peisker, VP of As Version 10/17/2016 Contractor's Bid for Public Works - I Date: 4/10/18 I 111114,0 rations R PO RA AVI )I '116110100000%