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sourt BF��_ <br />CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name High Street Sidewalk Project <br />Project No. 123-012 <br />For Bids Due May 14, 2024 <br />From time to time the South Bend Board of Public Works finds it necessary to reject a bid because <br />iIt 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 />✓ 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 />V This checklist submitted with the Bid. <br />This checklist <br />is provided for <br />bidder's use <br />in assuring compliance with <br />required <br />documentation; <br />however, it does <br />not include all <br />specifications requirements and <br />does not <br />relieve the bidder of the need to read and comply with the specifications. <br />Bidder: Premium Concrete Services Inc. <br />By Authorized Represen ative: <br />Signature:" <br />Print Name & Title: <br />Austin Redding <br />Date: 5/14/24 <br />Version 07/19/2023 Contractor's Bid for Public Works - 1 <br />