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Project Name OffsIte Parking Lot at Wayne St., and St. Louis Boulevard <br />Project No. 117-083B <br />For Bids Due July 10, 2018 <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 Ibid 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,O]. If minimum participation goal is not <br />met, also provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBEfWBE Contacted <br />X Form I[MWBE-2.1]. <br />X Acknowledge Receipt of 1 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 />X 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 />Bidder: Walsh & Kelly. Inc. <br />By Authorized Representativ� <br />pe" <br />Signature: Z� <br />Print Name & Title: 13fin Hilarv. VP of South Bend <br />Version 10/17/2016 Contractor's Bid for Public Works - 1 <br />Date: 7/10/18 <br />