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Project Name Two -Way Conversion of Colfax Avenue <br />Project No. 115-053A <br />For Bids Due April 24,2018, Due 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 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 -Collusion 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 MBE/WBE Participation Goal Form [MWBE-1.0]. If minimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2.,0] and MBEIWBE Contacted <br />X Form [MWBE-2.1]. <br />X Acknowledge Receipt of 1 Addendum(s) included with the bid. <br />X 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 />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 not include all specifications requirements and does not <br />relieve the bidder of the need to read, and)comply with the specifications., <br />Bidder: V <br />By Authorized <br />Signature: <br />Print Name & <br />Version 10/17/2017 <br />Date: 4,/24/118 <br />IV <br />Qds/fin Hilary, ouch Bend Qbencl Area Manage <br />:Z _J <br />< - tl <br />Contractor's Bid for Public Works - 1 <br />,,,, e?,f <br />