Form 96 - Contractors Bid For Public Work - Indiana
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CONTRACTOR'S BID FOR PUBLIC WORK - FORM 96
State Form 52414 (R2 / 2-13) / Form 96 (Revised 2013)
Prescribed by State Board of Accounts
PART I
(To be completed for all bids. Please type or print)
Date (month, day, year):__________________________
1. Governmental Unit (Owner):___________________________________________________________
2. County :___________________________________________________________________________
3. Bidder (Firm):_______________________________________________________________________
Address:___________________________________________________________________________
City/State/ZIPcode:__________________________________________________________________
4. Telephone Number:__________________________________________________________________
5. Agent of Bidder (if applicable):__________________________________________________________
Pursuant to notices given, the undersigned offers to furnish labor and/or material necessary to complete
the public works project of _____________________________________________________________________
(Governmental Unit) in accordance with plans and specifications prepared by _____________________________
_________________________________________________ and dated _____________________ for the sum of
____________________________________________________ $_____________________________________
The undersigned further agrees to furnish a bond or certified check with this bid for an amount specified in the
notice of the letting. If alternative bids apply, the undersigned submits a proposal for each in accordance with the
notice. Any addendums attached will be specifically referenced at the applicable page.
If additional units of material included in the contract are needed, the cost of units must be the same as
that shown in the original contract if accepted by the governmental unit. If the bid is to be awarded on a unit
basis, the itemization of the units shall be shown on a separate attachment.
The contractor and his subcontractors, if any, shall not discriminate against or intimidate any employee,
or applicant for employment, to be employed in the performance of this contract, with respect to any matter
directly or indirectly related to employment because of race, religion, color, sex, national origin or ancestry.
Breach of this covenant may be regarded as a material breach of the contract.
CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS
(If applicable)
I, the undersigned bidder or agent as a contractor on a public works project, understand my statutory
obligation to use steel products made in the United States (I.C. 5-16-8-2).
I hereby certify that I and all
subcontractors employed by me for this project will use U.S. steel products on this project if awarded.
I
understand that violations hereunder may result in forfeiture of contractual payments.
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