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CITY OF SOUTH BEND, INDIANA <br />CONTRACTOD FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project Name HOWARD PARK REDEVELOPMENT <br />Project No. 117-047-B <br />For Bids Due August 28, 2018 9:30 am. EST <br />From time to time the South Bond Board of Public Works finds it necessary to reject bid because it does not comply <br />with statutory requirements. In preparing your bid, please use the following checklist in order to make sure that your <br />bid is done in the proper manner. <br />x Proper bid security included. The bidder has the option of providing either a Certified Check or Bid Bond. <br />X Bid prepared on the City of South Bend Contractor's Bid for Public Work Form, completely executed. <br />x Contractor's Non -Collusion and Non -Debarment Affidavit, Certification Regarding Investments with Iran, <br />Employment Eligibility Verification, Non -Discrimination Commitment, and Certification of use of United States <br />Steel Products or Foundry Products. <br />x Proof of MB,E/WBE Participation Goal Form [MWBE-1.0]. If minimum participation goals is not met, also <br />provide Evidence of Good Faith Efforts Form [MWBE-2.0] and MBE/WBE Contacted Form [MWBE-2.1 j. <br />x 51 <br />Acknowledge Receipt of , 2 1, 4dendum(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 printed or typed <br />underneath signature. <br />X This checklist submitted with the Bid. <br />This, checklist is provided for bidder's use In assuring compliance with required documentation; however, it <br />does not include all specifications requirements, and, does not relieve the bidder of the need to read and <br />comply with the specifications. <br />Bidder: Larson Danielson Construction Company, Inc. — Date: 8/28/18 <br />By Authorized Representative: <br />Signature: x <br />Print Name & Title: Timothy F. Lar_aQn, Presidpnt <br />SON <br />OFN DAN SON <br />AR47 <br />�w ELSON <br />IC <br />LAR�SON DANIELSON <br />Go <br />A� , CO JCT <br />'A ON <br />GO., INC. <br />CONSTROCTION GO,, INC, <br />HOWARD, PARK REDEVELOPMENT 00 40 00-1 <br />Project No, 117-047-8 CONTRACTOR'S BID FOR PUBLIC WORK <br />