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<br />2 <br /> <br /> <br /> <br />7. Is applicant registered, or willing to register, in the System for Award Management (SAM)? ☐ Yes, currently registered ☐ Not currently registered, but willing to complete (the City can provide a registration guide) ☐ Not registered, and will not complete <br /> <br />8. Please list any residential property owned solely or co-owned by you within the City of South Bend: <br /> <br /> ____________________________________________________________________________________ <br /> <br />____________________________________________________________________________________ <br /> <br />I certify that the answers provided are true and accurate to the best of my knowledge: ☐ Yes ☐ No <br /> <br />I understand that if placed on the Registry, I will receive notice of opportunities to bid on Lead Hazard <br />Reduction Program work. And I understand that work will be awarded to the lowest, responsive and <br />responsible bid: ☐ Yes ☐ No <br /> <br />I have read and agree to the minimum specifications and program conditions for participation in the Lead <br />Hazard Reduction Program’s Registry of Pre-Qualified Contractors. ☐ Yes ☐ No <br /> <br /> <br /> <br /> <br /> <br />Signature Date <br /> <br /> <br /> <br />Name (Printed)