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0 <br />CITY OF SOUTH BEND, INDIANA MACK <br />V <br />CONTRACTOR'S BID FOR PUBLIC WORK <br />CHECKLIST FOR BIDDERS <br />Project, Name Lincoln Way East (SR 933) Corridor Improvements — Sample Street To <br />- Twyckenham Drive <br />Project No. 117-OSSA <br />For Bids Due September 61h, 2018 <br />From time to time the South Send 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-Colluslon 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, aiso provide Evidence of Good Faith Efforts Form [MWBE-2.01 and MBEIWBE Contacted <br />X Form tMWBE-2.11. <br />X Acknowledge Receipt of #1 Addendum(s) Included with the biid. <br />X Ali 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 doles not include all specifications requirements and does not <br />relieve the bidder of the need to read and comply with the specifications. <br />Bidder: Rieth-Riley Construction Co., Inc. Date-, September 6, 2018 <br />By Authorized Representative: <br />Signature: <br />Print Name & Title: Jos4X_Mcp , ltk, Sales Manager <br />Version 7120/2018 Contractor's Bid for Public Works - 1 <br />