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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDE12S <br />�jtlroject Name 2020i Contractor Paving <br />project No. 120-030 <br />For Bids Due May 26, 2020, 9:30 a,m.i, Local Tim.,.& <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 />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 - Collusion and: Non -Debarment Affidavit, Certification Regarding Investments <br />With Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and <br />Certification of use of United States Steel Products or Foundry Products, <br />Proof of MBEIWBE Participation Goal Form [MWBE-1.0], If minimurn participation goal is not <br />niet, also provide Evidence of Good Faith Efforts Forrn [MWBE-2,O] and MBE/WBE Contacted <br />Form [MWBE-2.1), <br />V Acknowledge Receipt of Addendum(s) Included with the bid, <br />V_ All required additional information is included with the bid. <br />Proposal statements and other affidavits at signed by the proper, party with name either <br />printed or typed underneath signature, <br />V­ 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 ail specifications requirements and does not <br />relieve the bidder of the need to read and comply with the specifications, <br />Bidder: Beth -Kiley Construction Co., Inc. <br />fate; 26, 2020 <br />By Authorized Representative: <br />Signature, <br />Print Narne & Tifle: Soles Manager <br />Version 402019, Contractor's Bid for Public Works - 1 <br />