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4 <br />C9 <br />CITY OF SOUTH BEND, INDIANA' X'3 <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name Ward Bakery Exterior Improvements <br />Project No. 121-061R <br />For Bids Due December 14, 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 />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 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/WBE Contacted Forms [MBE -2.1 and <br />WBE-2.1]. <br />Acknowledge Receipt of Addendum(s) included with the bid. <br />I 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 an does not <br />relieve the bidder of the need to read and comply with the specifications. <br />Bidder: <br />MA tkh, Date: l% <br />By Authorized Representative' - <br />Signature:E <br />Print Name & Title: i� F ( ir„ <br />Version 09/29/2021 Contractor's Bid for Public Works - 1 <br />