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SNE. ATP _ <br />8; 4a CONTRACTOR'S BID FOR PUBLIC WORK - FORM 96 <br />State Form 52414 (R2 t2-13)! Form 96 (Revised 2013) <br />rc Prescribed by State Board of Accounts <br />PART <br />(To be completed for all bids. Please type or print) <br />Date (month, day, year). 3/21/2022 <br />1. Governmental Unit (Owner): City of South Bend <br />2. County: St J <br />3. Bidder (Firm): Bit -Mat Products of Indiana <br />PO Box 428 <br />City/StatelZlPcode: Ashley, IN 46705 <br />4. Telephone Number: 260-587-9113 <br />5. Agent of Bidder (if applicable): NIA <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 <br />(Governmental Unit) in accordance with plans and specifications prepared by City of South Bend <br />and dated 3/21/2022 for the sum of <br />One Hundred Seventeen Thousand, Five Hundred $ 117,500.00 <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 />(!f 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 (l.C. 5-16-8-2). 1 hereby certify that I and al[ <br />subcontractors employed by me for this project will use U.S. steel products on this project if awarded. I <br />understand that violations hereunder may result in forfeiture of contractual payments. <br />