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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name 2021 Curb and Sidewalk ConstrUCtion <br />Project No. 121-001 <br />For Bids Duo <br />J u rte 8a 2021 at :00am Local Time to by b id(d,)oythbend i n ov <br />From timefime to time the South Bead Board of Public Works finds rids it necessary to reject a bid because <br />it does riot comply with statutory requirements. In prepar'ing your bid, please use the fol to ci n <br />checklist i n order to make sure that your bid is done in the proper manner. <br />Proper bid security included. The bidder has the option of pro id'Ing other a Certified Check <br />or Bid Bond. <br />Bid prepared on the City of South BendContractor's Bid for Public Work Farm, completely <br />executed, <br />Contractor's ton -Collusion and Non -Debarment Affidavit, Certification Regarding Inve Iment <br />with Iran, Employment Eligibility V r-ifi at'lon, fon-Di Brim-Ination Commitment, and <br />Certification of use of United States Steel Products or Foundry Products, <br />Proof of MWBF Utilization Plan [I I BB -1.0]_ If minimum participation goal is not met, also <br />provide Evidence of Good Faith Efforts Fora [M B E- . 0] and MWBE Contacted Form <br />[M BB- .1]. <br />Acknowledge ledge 1 ec ipt of Addendum(s) included with the bid, <br />All required additional information is included with the hid. <br />Proposal statements and other affidavits all signed by the proper party with name either <br />printed ort ped 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; _ (� l' � -� � . � Date- 7 - <br />By <br />� <br />Authorized Representative: <br />Signature - <br />Print Name & Title: <br />Ver ion 01 /13/2021 <br />.I' <br />9f e3 <br />Cr 51 de <br />_n u) i- CZ d c, <br />Contractor's Bid for Public Works - 1 <br />