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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />From time to time the South Bend Board of Public Works finds it necessary to rejectabid because <br />it does not comply with statutory requirements. In preparing your bid, please use the following <br />checklist inorder tomake sure that your bid imdone inthe proper mariner. <br />Proper bid security included. The bidder has the option mfproviding either eCertified Check <br />or Bid Bond. <br />Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely <br />Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments <br />with |nen. Employment Eligibility Verification, Non- Dioohmination 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 minimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted <br />Acknowledge Receipt mfo __Addendum(e)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 />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 RAM Date: _5:26-20E0 <br />BbAuthorized Representative: <br />Signature: _�?_ )/,4/ <br />Print Name &Title: / <br />Version 4/2/2019 Contractor's Bid for Public Works - 1 <br />