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I. PRE -QUALIFIED BIDDER CHECKLIST <br />(a) Acknowledgements: <br />(i) X By checking this box, I hereby acknowledge that I am a pre -qualified bidder with <br />the City of South Bend and that I have met the pre -qualification requirements within <br />the last twelve (12) months. A copy of my Pre -Qualification verification letter <br />is attached. <br />(ii) X By checking this box, I hereby acknowledge that the City reserves the right to <br />request supplemental information, additional verification of any information <br />provided by me, and may also conduct random inquiries of my current and prior <br />customers. <br />(b) Attachments: <br />(i) X indiana Secretary of State"s° on -fine records (ie Business verification) dated within <br />sixty (60) days of the submission of said document showing that business is in <br />existence, current with the Indiana Secretary of State's Business Entity Report„ <br />and eligible for a certificate of good standing, (foot applicable to individuals, sole <br />proprietors or partnerships), <br />X.... Statement on staffing ca,pabalities, Including labor sources. This statement <br />Indicales and ensures I have :sufficient e rnployees on stuff to complete the work. It <br />outlines how i intend to rneet the staffing needs of the work, <br />X Evidence that I am utilizing a surety company which is on the United States <br />Department of Treasury's Listing of Approved Sureties as required in the bid <br />specifications or contract. <br />(iv) X„wy List of projects of similar size and scope of work performed in all areas, including <br />the State of Indiana, within the last three (3) years. <br />(v) X , For every project, submit evidence of participation in apprenticeship and training <br />programs, applicable to the work to be performed on the project, which are <br />approved by and registered with the United States Department of tabor's Office of <br />Apprenticeship, or its successor organization, <br />Version 3/19/2019 General Conditions - 8 <br />