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" <br />CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name 2023 street and Sewer Material Bid <br />Project No. 123-019 <br />For was Due March 28, 2on 9:0o 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 />N!A Proper bid security included. The bidder has the option of providing either a Certified <br />Check or Bid Bond, NOT REQUIRED <br />/ Bid prepared on the City of South Bend Contractor's Bitl for Public Work Form, <br />V completely executed, <br />Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding <br />Investments with Iran, Employment Eligibility Verification, Non -Discrimination <br />/ Commitment, and Certification of use of United States Steel Products or Foundry <br />V Products. <br />Proof of MNVBE Utilization Plans [MBE-1.0 and WBE-1.0]. Also provide Evidence of <br />Good Faith Efforts Forms [MBE-2.0 and WBE-2,0] and M/ BE Contacted Forms [MBE- <br />1 and WBE-2.1]. NOT REQUIRED <br />Acknowledge Receipt of U Addendum(s) included with the bid. <br />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, tt 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 d'Gru5ot Wa4:cr"rI,5 Date: �l�710 <br />By Authorized Representative: <br />Signature; <br />Print Name &Title: <br />