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O <br />r <br />CITY OF SOUTH BEND, INDIANA y <br />CONT CTO S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name Privet Lane Culvert Replacement Project <br />Project No. 118-013B <br />For Bids Due December 10, 2019 <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 Eli,gibiiity Verification, Non-DiscriminationCommitment, and <br />X Certification of use of Ignited States Steel Products or Foundry Products. <br />Proof of MBEIWBE 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 Form [MWBE-2,11'. <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 />mX 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: <br />G.E. Maw <br />By Aut orl�d,- pep <br />Signature: <br />Print Name & Title: <br />Version 10/17/2017 Contractors Bid for Public Works - 1 <br />