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ZI LI K A <br />� <br />Moi N 113 1111 lo] " .4 :11rr <br />Project Name Ameritech Drive Pavement Improvements <br />Project No. <br />For Bids Due <br />117.057A <br />June 12, 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 MBEIWBE Participation Goal Form [MiWBE-1,0]. If minimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2.,0] and MBEPVVBE 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: Walsh & Kelly, Inc. <br />By Authorized Represe <br />Signature: <br />Print Name & Title: in U. <br />a <br />Version, 10/17/2016 Contractor's Bid for Public Works - 1 <br />Date: 6/12/18 <br />KE Lt k <br />........... <br />t <br />Z, <br />Ali I <br />/ND1 <br />10�11111000 <br />