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proj,ect Narne Morris Performing Arts Center <br />Morris Bistro/Palms Improvements <br />proieet NQ_ 1031-2017 <br />For Bids Due December 21, 2017 9:30 AM <br />Frorn time to time the South Bend Brkmd of Public, or finds it newssary to reJecq a bid because <br />it does not compty vwth statutory irequire ments. In preparkig Vattr bid, please use the foRowing <br />checklist in order to make sure that. your mid us done in the proper manner. <br />Proper bid securdy included. The Wdder has the ophon of providing eigher a Cedifted Ctwck <br />or Bid Bond. <br />Bid prepared on 11he City d Suuth Bend Conlract(Ws Bid for Public Work FoTm. (=npletely <br />execute,d. <br />Contractars Non -Collusion and Non -Debarment Affidavil, Ceylification Regarding Inveshvients, <br />with Iran, Employmen! Efiq'jUlhy VehficaWvon, Nora- D4sr,6jwD1n&Won Commalmena, and <br />Certification of use of United States Steel Products or Foundiy Paxlurcls. <br />Proof of MBEIWBE Parlicipation Gael Form it aiin(rnum participaVon goal is not <br />met, also provide Eviklenre of Gnud Faith Effods Form JMWBE-22.01 and MBEMBE Contacted <br />Form [MWBE-2.11. <br />V" Acknowledge Receipt of Addendunn(s), included rug h the bid.. <br />All required addiflonall ijinfomnnaWi it rnrOuded wiM Me Md. <br />Proposal statements and Wier affidavits alil signedi by the Proper party with name either <br />print or typed auto devmalh!Mro ,;natlme. <br />This checklist submitted with the Did <br />This checklist its provided for b,iddees amse in assufring compliance Walb required <br />documentation; however, it does not include all spy ecNications requirements and does not <br />relieve the bidder of the need to fead ;and comply with the speci,fications. <br />Bidder: Dalw <br />By Authorized Representafiv�&: <br />Signature, <br />Print Narne& Title- <br />:X iAb A3.,.-A <br />Version 10/17'12016 Conhadei"s Did for PoWc Vecgks - 11 <br />