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'PEACE, <br />CITY OF SOUTH BEND, INDIANA t1365 <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name 2021 Street and Sewer Material Bid <br />Project No. 121-018 <br />For Bids Due April 13, 2021, 9:00 a.m., Local Time <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 />ontractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments <br />,ith Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and <br />Certification of use of United States Steel Products or Foundry Products. <br />Proof of MWBE Utilization Plan [MWBE-1.0]. If minimum participation goal is not met, also <br />provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MWBE Contacted Form <br />[MWBE-2.1 ]. <br />Acknowledge Receipt ofAddendum(s) included with the bid. <br />t, 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: <br />By Authorized Re <br />Signature: <br />Print Name & Titl( <br />&I <br />`0 Awc4j Date: [A -R _ 0a I <br />Version 01 /13/2021 Contractor's Bid for Public Works - 1 <br />