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CITY OF SOUTH BEND 'OUTQ e <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY has <br />:. <br />DEVELOPMENT PROGRAM G 5 <br />FORM MWBE-2.1 <br />MBE/WBE CONTACTED na <br />This completed form should be supplied with was 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 3 OF 3 <br />Project Number: 116-053 MBE/WBE Participation Goal 7.1 % <br />Project Name: Calvert Street Lift Station Replacement <br />Bidders p Selge Construction Co., Inc <br />BY: tvl- �— Pro'ect Eh ineer 12 08 16 <br />(Signature)Robert Kuhns (Title) (Date) <br />MBEIWBE Firm State Barricading, Inc. <br />Owner or Contact at MBE/WBE Firm James Michalski <br />Telephone: (574)287-2078 Fax: (574)287-1744 Email: <br />Statebarricade1@aol.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Construction Signacle & Maintenance of Traffic <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Quoted <br />MBE/WBE Firm Laporte Construction Co., Inc. <br />Owner or Contact at MBE/WBE Firm Jake DeHaven <br />Telephone: (219)393-5555 Fax: <br />Email:jdehaven@laporteconstruction.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Cast - In Place Concrete Structure <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Version 10/18/2016 Contractor's Bid for Public Works - 11 <br />