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CONTRACTOR'S BID FOR PUBLIC WORK - FORM 96 <br />1� State Form 52414 (R212-13) / Form 96 (Revised 2013) <br />Prescribed by State Board of Accounts <br />PART <br />(To be completed for all bids. Please type or print) <br />Date (month, day, year): 10/26/2021 <br />1. Governmental Unit (Owner): City of South Bend, Indiana <br />2. County: St. Joseph - - <br />3. Bidder (Firm):. Milestone Contractors North, Inc. <br />Address: 24358 SR 23 — <br />City/State/ZlPcode:_ South Bend, IN 4fQg 4 _ <br />4. Telephone Number: 574-288-481 j <br />5. Agent of Bidder (if applicable): <br />Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete <br />the public works project of City of South Bend. _Indtan� <br />(Governmental Unit) in accordance with plans and specifications prepared by <br />The City of South Bend Public Works - Engineering Dept. and dated 7/20/20 & 10/7/21 for the sum of <br />See Attached _ <br />$ See Attached <br />The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the <br />notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the <br />notice. Any 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 <br />that shown In the original contract if accepted by the governmental unit. If the bid Is to be awarded on a unit <br />basis, the itemization of 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, <br />or applicant for employment, to be employed in the performance of this contract, with respect to any matter <br />directly or indirectly related to employment because of race, religion, color, sex, national origin or ancestry. <br />Breach of this covenant may be regarded as a material breach of the contract. <br />CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS <br />(lf applicable) <br />I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory <br />obligation to use steel products made in the United States (I.C. 5-16-8-2). 1 hereby certify that I and all <br />subcontractors employed by me for this project will use U.S. steel products on this project if awarded. l <br />understand that violations hereunder may result in forfeiture of contractual payments. <br />