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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name 2019 Community Crossings Round 2 <br />Project No. 119-065 <br />..............................._..... <br />For Bids Due November 26, 2019, 9:30 a.m., Local Time <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 />X 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 MBE/WBE 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 aomply with the specifications. <br />Bidder: Walsh & Kelly. In <br />By Authorized <br />Signature: <br />Print Name & <br />Version 4/2/2019 <br />ustin Hilarv, VP of South Bend Area <br />Contractor's Bid for Public Works - 1 <br />Date: 11 /26/19 <br />i,til l I ml,', <br />& KELLy <br />.�s <br />w <br />wMw ,p: pv <br />/NDIO <br />il11111110,4 <br />