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4 H8 a <br />Oy <br />P .AGd: <br />CITY OF SOUTH BEND, INDIANA'. <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name City of South Bend 2021 Drainage Improvements — Kaley St & Marion St <br />Project No. 121-006A <br />For Bids Due August 24, 2021 <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 />X or Bid Bond. <br />Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely <br />X executed. <br />Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments <br />with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and <br />X Certification of use of United States Steel Products or Foundry Products. <br />Proof of M/WBE Utilization Plans [MBE -1.0 and WBE-1.0]. Also provide Evidence of Good <br />Faith Efforts Forms [MBE -2.0 and WBE-2.0] and M/ BE Contacted Forms [MBE -2.1 and <br />X WBE-2.1 ]. <br />X Acknowledge Receipt of 1 Addendum(s) 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 />X 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: Milestone Contractors NortiV nc. Date: 8/24/2021 <br />By Authorized Representa#w <br />Signature: <br />Print Name & Title:stin P. Hilary, Director of Estimating <br />Version 08/16/2021 Contractor's Bid for Public Works - 1 <br />