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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name 2024 Street& Sewer Material Bid <br />Project No. 124-004 <br />For Bids Due March 12,2024,9:00 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 />NIA Proper bid security included. The bidder has the option of providing either a Certified Check <br />or Bid Bond. NOT REQUIRED <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 <br />Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, <br />and Certification of use of United States Steel Products or Foundry Products, <br />Proof of MNVBE Utilization Plans [MBE-1.0 and WBE-1,0], Also provide Evidence of Good <br />Faith Efforts Forms [M BE-2.0 and WBE-2. 0] and M/WBE Contacted Forms [M BE-2.1 and <br />VVB E-2. I]. NOT REQUIRED <br />Acknowledge Receipt of 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 />Y' printed or typed underneath signature, <br />X 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. <br />Bidder: OZ. I t-A(, 6 0) Date: 3 42 - 2- <br />By Authorized Representative: <br />Signature: L, X�U� <br />Print Name & Title: 'B f- i wij w , m i <br />