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State Form 52414 (R / 9-10) <br />Prescribed bv, State Board of Accounts Formi Nos6��i ed 2013 <br />CONTRACTOR'S BID FOR PUBLIC WORK — FORM 96 <br />PART 1 <br />(To be completed for all bids. Please type or print) <br />1. Governmental Unit (Owner): <br />2. County: <br />3. Bidder (Firm): <br />Address: <br />City/State: <br />4. Telephone Number: <br />5. Agent of Bidder (If applicable): <br />Date (month, day, year): May-26t 2020 <br />Cily of South Bend, Indiana <br />$t.,.. Josef?h,. <br />Wals...h..... K.e....1.1'.�..I.....n....c.,................................................................................................................................................................_ <br />24358 SR 23 <br />South _.. , <br />out....._Ben._.�..IIv....4....,_...._.14......._.�.�.........__..................._....._—�. <br />(574. 288-4811 <br />Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete the public <br />works project of __Ci ` of South Bend,; Indiana (Governmental Unit) in accordance with plans and specifications <br />prepared by Cit.� f South Bend Indiana — Dept. of Public Works and dated Maw 7, 2020 for the sum of <br />Att See Attached $ See ached <br />The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the notice of <br />the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the notice. Any <br />addendums attached will be specifically referenced at the applicable page. <br />If additional units of material included in the contract are needed, the cost of units must be the same as that shown <br />in the original contract if accepted by the Governmental Unit. If the bid is to be awarded on a unit basis, the itemization of <br />the units shall be shown on a separate attachment. <br />The Contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee, or <br />applicant for employment, to be employed in the performance of this contract, with respect to any matter directly or <br />indirectly related to employment because of race, religion, color, sex, national origin or ancestry. Breach of this covenant <br />may be regarded as a material breach of the contract. <br />CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS <br />(If applicable) <br />I, the undersigned bidder, or agent as a contractor on a public works project, understand my statutory obligation <br />to use steel products made in the United States. I.C. 5-16-8-2. 1 hereby certify I and all subcontractors employed by me for <br />this project will use U.S. steel products on this project if awarded. I understand that violations hereunder may result in <br />forfeiture of contractual payments. <br />2 <br />