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• <br />CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name Fire Station #4 <br />Project No. <br />For Bids Due <br />166-066 <br />December 13, 2016 <br />From time to time the South Bend Board of Public Works finds it necessary to reject a bid because <br />it 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 />f 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 MBE/WBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted <br />Form [MWBE-2.1]. <br />V Acknowledge Receipt of 3 Addendum(s) included with the bid. <br />i"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 />rJ printed or typed underneath signature. <br />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 bid/d'er, of the need <br />need to read and comply with the specifications. I <br />Bidder: (Jf P I 1 t1' l$ Y LCG�I�(! L L Date: I d J, (O <br />e <br />By Authorized RepresentTat, <br />; <br />Signature: ,�" <br />Print Name & Title: d�f I ati 'B I CI ,_ -L-L, c ((Ys / cleat <br />Version 10/18/2016 Contractor's Bid for Public Works - 1 <br />