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PRE -QUALIFIED BIDDER CHECKLIST <br />(a) Admowledgwoft <br />(i) By ehecdng this box, I hmby acmowkdge that I am a pre polfkd bidder with <br />the My of South Bend and that I have met the pre-quaffmallon requirements within <br />the last twelve (12) months. A copy of my Pr+e-Qun vermin limber <br />Is attached. <br />(li) By checl g this back, I her* acknowledge that the City reserves the right to <br />request supplemental Intonnation, additional verification of any Inforrrnafian <br />provided by me, and may also corctuc random Inquiries of my current and PrW <br />arsIMmera. <br />(in) By checking thk box, I hereby admowledge that app w&.m ip and training <br />programs that I padbipate In have graduated at kart five (5) apprentices In each <br />of the past tine (5) years. <br />(IV) By checking this box, I hereby acknowledge that all subcontractors perfonMnng <br />work greater than $250,000 also meet the qualifications of the Responsible Bidder <br />Ordinance. <br />(b) Atkchmen <br />(t) SZ Indiana Secretary of State's on -tine records (le. Business verification) dated within <br />My (50) days of the submission of said document stowing that business Is In <br />existence, current with the Indiana Secretary of State's Business Entity Report, <br />and eligible for a certificate of good standtng. (Not applicable to Individuals, sole <br />proprktors or parinershdps). <br />(ii) Statement on staffing capabil <br />itks, Including tabor sources. This statement <br />Indicates and ensures I have suftdod employees on staff to complete the wok It <br />outlines how I Mend to meet the staffing needs of the work <br />(to List of projects of skit size and scope of work performed In all arms, Incl4 ng <br />the State of Indiana, within the fast three (3) years. <br />(IV) ,� For every project submit evidence of partictpatfon in apprentioeship and training <br />program, applicable to the work to be performed on the project, which are <br />approved by and registered with the United States Department of LaWs Office of <br />AppmdUmhtp, or Is successor organization. This includes, butnay not be limited <br />to, letters from apprenuticoeMp coordinators detaft the bites won with <br />the program, and the United Staffs Department of Labor Office afApprenfheshdp <br />Certificates ofRegktratimpre m ofApntkeship Programs for each type ofwcrk to be <br />perlormed on the project. <br />Verskm 62012M4 Get MI Canons -13 <br />