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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name 2023 Curb and Sidewalk Program <br />Project No. <br />For Bids Due <br />123-001 <br />ust 8'", 2023 <br />U1'H g <br />��O � <br />����� � sI <br />t '���� <br />z �` `'�_ x ,�4 <br />% Idfi5 <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 fallowing <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 />v 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 MIWBE 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 y 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 />C/ 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. J <br />Bidder: �/���+iSCIi''J CdaGR�T� SE.4dzGE 5 Date: ✓�/8/�%7 <br />By Authorized ReprP��^`�+����� <br />Signature: <br />Print Name &Title: <br />Version 09/29/2021 Contractor's Bid for Public Works -1 <br />