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PRE -QUALIFIED BIDDER CHECKLIST <br />(a) Acknowledgements: <br />(i) ✓ <br />By checking this box, I hereby acknowledge that I am a pre -qualified bidder with <br />the City of South Bend and that I have met the pre -qualification requirements within <br />the last twelve (12) months. A copy of my Pre -Qualification verification letter <br />is attached. <br />By checking this box, I hereby acknowledge that the City reserves the right to <br />request supplemental information, additional verification of any information <br />provided by me, and may also conduct random inquiries of my current and prior <br />customers. <br />(b) Attachments' <br />(i) <br />Indiana Secretary of State's on-line records (ie. Business verification) dated within <br />sixty (60) days of the submission of said document showing that business is in <br />existence, current with the Indiana Secretary of State's Business Entity Report, <br />and eligible for a certificate of good standing. (Not applicable to individuals, sole <br />proprietors or partnerships). <br />(ii) <br />Statement on staffing capabilities, including labor sources. This statement <br />indicates and ensures I have sufficient employees on staff to complete the work. It <br />outlines how I intend to meet the staffing needs of the work. <br />(iii) Y <br />Evidence that I am utilizing a surety company which is on the United States <br />Department of Treasury's Listing of Approved Sureties as required in the bid <br />specifications or contract. <br />(iv) <br />List of projects of similar size and scope of work performed in all areas, including <br />the State of Indiana, within the last three (3) years. <br />PRE -QUALIFICATION CHECKLIST (FOR BIDDERS THAT ARE NOT PRE -QUALIFIED) <br />(a) Acknowledgements: <br />(i) _ By checking this box, I hereby acknowledge that I am not a pre -qualified bidder <br />with the City of South Bend. <br />By checking this box, I hereby acknowledge that the City reserves the right to <br />request supplemental information, additional verification of any information <br />provided, and may also conduct random inquiries of my current and prior <br />customers. The City reserved the right to utilize all information provided in this <br />submission and all information obtained in inquiries or requests to determine if a <br />bidder is responsive and responsible. Additionally, I acknowledge that all <br />information provided to the City shall be regarded as public records. <br />By checking this box, I hereby acknowledge that copies of all Applicable <br />apprenticeship certificates or standards for training programs applicable to the <br />work performed on the project may be requested at any time and shall be furnished <br />upon request. <br />(iv) _ By checking this box, I hereby acknowledge and ensure that I and all sub- <br />contractors, from whom I have accepted a bid and/or intend to hire to perform work <br />on the public work project, are properly licensed. Furthermore, I acknowledge my <br />understanding that it is my responsibility to ensure that all sub -contractors have <br />the necessary licenses to undertake the work called for in this bid. If a sub- <br />contractor loses their license at any point, it is the responsibility of that sub- <br />contractor to notify the City. <br />(b) Attachments: <br />Version 8/16/2018 Special Provisions - 8 <br />