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o sou x aJJ <br />ry cr <br />CITY OF SOUTH BEND, INDIANA"if e5 <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name Demolition of the South Bend Medical Foundation, 531 N. Main Street, <br />South Bend, IN <br />Project No. 123-076 <br />For Bids Due 14 May 2024 <br />From time to time the South Bend Board of Public Works finds it necessary to reject a bid <br />because it does not comply with statutory requirements. In preparing your bid, please use the <br />following 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 />X or Bid Bond. <br />Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely <br />X executed. <br />Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments <br />with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and <br />X 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 />X Faith Efforts Forms [MBE-2.0 and WBE-2.01 and M/WBE Contacted Forms [MBE-2.1 and <br />WBE-2.1]. <br />X Acknowledge Receipt of Addendum(s) included with the bid. <br />X All required additional information is included with the bid. <br />X Proposal statements and other affidavits all signed by the proper party with name either <br />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: Dore & Associates, Inc. Date: 5/28/2024 <br />By Authorized Re%�'nta <br />Signature: <br />Print Name & Title: Jason C. Dore, President <br />Version 07/19/2023 Contractor's Bid for Public Works - 1 <br />