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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name 2024 Street & Sewer Material Bid <br />Project No. <br />124-004 <br />For Bids Due March 12, 2024, 9:00 a.m., Local Time <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 />N/A Proper bid security included. The bidder has the option of providing either a Certified Check <br />or Bid Bond. NOT REQUIRED <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 <br />Investments with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, <br />�. and Certification of use of United States Steel Products or Foundry Products. <br />Proof of IVl�11B Utilization Plans - 0 and BE-1.O�AIso provide Evidence of Good <br />/ FaWLEfforts Forms [MBE-2.0 and WBE-2.0 and /WBE Contacted Forms [MBE-2.1 and <br />WBE-2.1 . NOT REQUIRED <br />� Acknowledge Receipt of� Addendum(s) included with the bid. <br />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 />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 />x r <br />Bidder: t V _ � )�' Al' ��, Date: <br />By Authorized Represgntative:, <br />Signature: <br />UU�,I'� <br />1 <br />—tttd LIo <br />Print Name & Title: <br />�`1<< CA <br />c <br />_6x_AL_ f (t _461 <br />Version 07/19/2023 Contractor's Bid for Public Works - 1 <br />