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PRE -QUALIFIED BIDDER CHECKLIST <br />(a) <br />(V �V_ Bychecking this box, | hereby acknowledge that |amapre'quaUfiedbidder with <br />the City ofSouth Bend and that ) have met the pre -qualification requirements within <br />the last twelve (13)months. Acopy oYnmyPre-Qualification verification letter <br />is attached. <br />(ii) v/ 8ychecking this box, i hereby acknowledge that the City reserves the right ho <br />request supplemental infonnmdion, additional verification of any information <br />provided byme, and may also conduct random inquiries ofmycurrent and prior <br />customers. <br />(iii) v/ By checking this box, | hereby acknowledge that apprenticeship and training <br />programs that | participate inhave graduated sdleast five (5)apprentices ineach <br />ofthe past five (5)years. <br />(iv) v^ By checking this box. | hereby acknowledge that all subcontractors performing <br />work greater than $25U.00Oalso meet the quu|ifimodonmofthe Responsible Bidder <br />Ordinance. <br />(b) Attachments: <br />� vx Indiana Secretary ofGtate on-line records <ie.Business verification) dated within <br />sixty (60) days of the submission of said document showing that business is in <br />exiob*nne, current with the Indiana Secretary ofQtate/s Business Entity Report, <br />and eligible for acertificate of good standing. (Not applicable tm indivkJunls, sole <br />proprietors orpertnenahipo). <br />(ii) v/ Statement on staffing oopmbi|biea, including labor sources. This statement <br />indicates and ensures | have sufficient employees onstaff hocomplete the work. |t <br />outlines how | intend b»meet the staffing needs nfthe work. <br />(iii) »/ List of projects of similar size and scope of work performed in all areas, including <br />v' the State ofIndiana, vv�hinthe last three (3)years. <br />(iv) For every pnoject, submit evidence ofparticipation in apprenticeship and training <br />pnogrumo, applicable bnthe work to be performed on the project, which are <br />approved by and registered with the United States Department of Labor's Office of <br />Apprenticeship, or its successor organization. This includes, but may not be limited <br />to, letters from apprenticeship coordinators detailing the bidder's association with <br />the program, and the United States Department of Labor Office of Apprenticeship <br />Certificates of Registration of Apprenticeship Programs for each type of work to be <br />performed on the project, <br />Version 5/20/2024 General Conditions -13 <br />