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CITY OF SOUTH BEND u_sourrr e��o <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />:r <br />DEVELOPMENT PROGRAM <br />w <br />FORM MWBE-2:1 W T e <br />MBE/WBE CONTACTED nas <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 2 OF 3 <br />Project Number: 116-053 MBE/WBE Participation Goal 7.1 % <br />Project Name: Calvert Street Lift Station Replacement <br />Bidder: n Selge Construction Co., Inc <br />~ kz� Project Engineer 12 08 16 <br />(Signature)RObert Kuhns (Title) (Date) <br />MBE/WBEFirm Conco Spray Solutions <br />Owner or Contact at MBE/WBE Firm Jennifer Hoop <br />Telephone: (317) 428-6543 Fax:(317) 791-2220 Email: jL222@concospray.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Interior and exterior structure coatings <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Quoted <br />MBE/WBE Firm Garcia Surveyors <br />Owner or Contact at MBE/WBE Firm Pat Johnson <br />Telephone: (260)440-8387 Fax: (260)440-8387 Email: pjohnson@garciasurveyors.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Construction Encrineerincr <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Version 10/18/2016 Contractor's Bid for Public Works - 11 <br />