Laserfiche WebLink
CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE-1.0 <br />193d1]r•10 <br />GOAL <br />q61 To a <br />n.I <br />Participation goal. It is the bidder's sole responsibility to verify whether any listed minority or woman business meets theIqualifications of a <br />Ainority or Women's owned business. <br />Project Number: 116.083D Project Name: Randolph Street Basin Emergencv Repair <br />Bidder I�� �0 r 7 g �Flyl �'v 1 c�� �. Total Bid Amount: Q I1, 0O y, 0 6 MBENVBE Goal: 7.1 <br />Page of <br />Name & Address of MBEANBE <br />Primary Contact Person <br />(NamelTelephone) <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need atltlitional space) <br />Dollar Amount of <br />MBE/WBE Component <br />Percentage <br />of Total <br />Bitl/P(/ro o <br />� <br />G0 \l G�T eyC,0f U'T(1O n J <br />/ �f <br />14 i7J I TZ <br />J /sal <br />, <br />O <br />�JU J6 �U✓0"t thdlY) <br />2,d <br />M 4r\( <br />+V-q F_t C, <br />� 0 3 <br />SoJ <br />/ <br />�T <br />Submitted by: r+1 n4� •' L,'/" wJG d� JC7 <br />Pam Dame Si ture Date <br />Version 7/2812016 Contractor's Bid for Public Works - 25 <br />