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toln"m ism gelma <br />I <br />Project Name Fire Station #9 <br />Project No. 116-012 <br />For Bids Due February 27, 2018 at 9:30 AM Local Time <br />From time to time the South Bend Board of Public Works finds it necessary to reject a bid <br />because it does not comply with statutory requirements. In preparing your bid, please use the <br />following 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 />X 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 Investments <br />X 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 />X met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/VVBE Contacted <br />Form [MWBE-2,1], <br />X Acknowledge Receipt of 11 2 1 '3 Addendum(s) included with the bid, <br />X All required additional information is included with the bid. <br />X Proposal statements and other affidavits all signed by the proper party with name either <br />— 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 not include all specifications requirements and does not <br />relieve the bidder of the need to read and comply with the specifications. <br />Bidder: Gibson -Lewis, LLC <br />By Authorized Represent I e: <br />Signature: <br />Print Name & Title: Robert A <br />President <br />Version 10/1:7/2017 Contractor's Bid for Public Works - I <br />Date: 2/27/18 <br />