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�pt1 T Fj �F <br />CITY OF SOUTH BEND, INDIANA <br />CONTRACTOR'S BID FOR PUBLIC WORK A, r��5` '•. ': <br />CHECKLIST FOR BIDDERS <br />Project Name Ironwood Drive Sidewalk Edison Road to S.R. 23 <br />Project No. 117-033A <br />For Bids Due December 12, 2017 <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-Colfusion and Non -Debarment Affidavit, Certification Regarding Investments <br />with Iran, Employment Eligibility Verification, Non -Discrimination Commitment, and <br />X Certification of use of United States Steel Products or Foundry Products. <br />Proof of MBEIWBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2.01 and MBEMBE Contacted <br />X Form [MWBE-2.1]. <br />X Acknowledge Receipt of 2 Addendum(s) included with the bid. <br />X Ali 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 <br />documentation; however, it does noude all specifications requirements and does not <br />relieve the bidder of the need to re#d an�omply wj* the specifications. <br />Bidder: WalsF <br />By Authorized <br />Signature: <br />Print Name & <br />Version 10/1712016 <br />Date: 12/12/17 <br />use ative: <br />© in Hilary, South Bend Area Manager <br />P��� <br />Contractor's Bid for Public Works - 1 <br />