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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM M4"iJ'BE-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 MBEA/VBE 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: <br />117-087 <br />Project Name: Old Clay Utilities Sewer <br />MBE,' VBE Participation Goal 7.1% <br />Bidder: Selge Construction Co.., Tnr_. <br />By: I Proiect Engineer 12/19/17 <br />(Signature) Robert P. Kuhns, P.E. (Title) (Date) <br />MBE/VVBE Firm State Barricading, Inc, <br />Owner or Contact at MBEMBE Firm —Mary Michalski <br />Telephone: 574-287-2078 Fax. 574-287-1744 Email. statebarricade@aol.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Maintenance of Traffic <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Ac,cepted bid <br />MBENVBE Firm Culy Contractincf <br />Owner or Contact at MBEMBE Firm Jonathan Moore <br />Telephone: 317-697-2024 Fax: 765-584-8060 Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Manhole Rehabilitation <br />RESULTS OF CONTACT WITH THE MBEIWBE FIRM: <br />Quote was high <br />Version 10117/2017 Contractor's Bid for Public Works - 10 <br />