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6 oV k <br />CITY OF SOUTH BEND <br />• MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY a <br />DEVELOPMENT PROGRAMoi '�'• <br />FORM MWBE-2.1 <br />MBE/WBE CONTACTED <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects <br />requiring contacted MBE/WBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify <br />whether any listed minority or woman business meets the qualifications of a Minority or Women's owned <br />business. <br />PAGE 1 OF <br />Project Number: 116-053 MBE/WBE Participation Goal <br />Project Name: Calvert Street Lift Station Replacement <br />Bidder: Grand River Construction, Inc. <br />By: Signature on Pagel ,M fl Rick Parcheta Vice President of Commercial December 8 2016 <br />(Signature) (Title) (Date) <br />MBEANBE Firm E.I.B. Communication <br />Owner or Contact at MBE/WSE Firm Ezzard Charles <br />Telephone: (219) 318-3616 Fax: N/A Email: eibchaeles@comcast.net <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Electrical <br />• <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />MBEJWBE Firm Electrical Maintenance & Construction <br />Owner or Contact at MBE/WBE Firm Tamara Glaser <br />Telephone: (812) 465-4362 Fax: (812) 465-0362 Email: tammy@4emc.net <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Electrical <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />• <br />Version 10/18/2016 Contractor's Bid for Public Works - 11 <br />