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LOM 0 <br />Project Name Press Ganey Administration Building Site Improvements <br />For Bids Due April 14, 2020 <br />J III I I A , a 1 11 , I , 0 it- 0 :0. a * 6 0 0 1 - - - a - - <br />IMMIWAIN10101 0 0 0 <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 />executed, <br />Contractor"s Non-Colluslon and Non -Debarment Affidavit, Certification Regarding Investments <br />with Iran, Employment Eligibility Verification, NoDiscrimination Commitment, and <br />Certification of use of United States Steel Products or Foundry Products, <br />Proof of MBE/WBE Participation Goal Form [MWBE-1 .0]. If miniimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWB01 and MBontacted <br />Form [MWBE-2.1]. <br />Acknowledge Receipt of -3- Addendum(s) included with the bid. <br />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 />printed or typed underneath signature. <br />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: - -Majority Builder s, Inc. Date: April. 14, 2020 <br />By Authorized Representat.,iv,15 : <br />Signature: g, '5 <br />Print Name & Title: David J. Piston/Vice President <br />Version 4/212019 Contractor's Bid for Public Works - I <br />