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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name "Berlin Place - BP#2 Electrical, Mechanical, & Plumbing" <br />Project No. 117-048R <br />For Bids Due Tuesday, June 13th1h by 9:30am <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 />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 />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 MBEIWBE Contacted <br />X Form [MWBE-2.1]. <br />X Acknowledge Receipt of I 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 />_ 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 bidder of the need to read and comply with the specifications. <br />Bidder: Herrman. & Goetz. Inc. <br />By Authorized Representative: <br />Signature: <br />Print Name & Title: <br />e. Power-of-Attorne <br />Date: .Tune 13, 2017 <br />Version 4/17/2015 Contractor's Bid for Public Works - 1 <br />