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CITY OF SOUTH BEND <br />V <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />7, <br />DEVELOPMENT PROGRAM <br />FORM MWBE-2.1 z� <br />MBE[WRE CONTACTED <br />This completed form should be supplied with Bids that pertain to City of South Bond 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 />PAGEOF' <br />Project Number: 117-127 <br />MBENVBE Participafion Goal <br />Project Name: South Bend Fire Department Training Center Classroom Building <br />=,.* sm <br />By: <br />/Gibson -Lewis. LLC <br />(Signature) I (Title) (Date) <br />MBENVBE Firm <br />1`11 1 A r F,,s 2X <br />Owner or Contact at MBENVBE Firm <br />Telephone: 5,7 Fax: .,)sa,,gkm Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBEMBE FIRM: <br />MBE/WBE Firm <br />Owner or Contact at MBE/WBE Firm <br />Telephone: Fax: Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBENVBE FIRM: <br />Version 10/17/2017 Contractor's Bid for Public Works - 10 <br />