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"I <br />CITY OF SOUTH BEND, INDIANA <br />Contractor's Bid for Public Work <br />CHECKLIST FOR BIDDERS <br />Project Name Newman Center: Roof Repair <br />Project No. 116-131 <br />For Bids Due 10:30 am, December 22, 2016 <br />From time to time the South Bend Board of Public Works finds it necessary to reject a bid because it does <br />not comply with statutory requirements. In preparing your bid, please use the following checklist in order <br />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 Slates Steel Products or Foundry Products. <br />Proof of MBEMBE',Participation Goal Form [MWBE-1.01. If minimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2,0] and MBEIWBE Contacted <br />X Form [MWBE-2.11. <br />X Acknowledge Receipt of 1 Addendum(s) included with the bid. <br />X 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 />X 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 documentation; <br />however, it does not include all specifications requirements and does not relieve the bidder of the <br />need to read and comply with the specifications. <br />Bidder: Midland Engineering Company, Inc. Date: December 22, 2016 <br />By Authorized Representative: <br />9 L :f <br />Si nature: <br />Print Name & Title: M.W. Frahn, Exec. V.P/CFO/Secretary <br />Version 10/17/2016 Contractor's Bid for Public Works - 1 <br />