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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE-2.1 <br />MBEMBE CONTACTED <br />This completed form should be supplliedl with Bids that pertain to City of South Bend Public Works Projects <br />requiring contacted MBEIWBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify <br />whether any listed minority or woman business meats the qualifications of a Minority or Women's owned <br />business. PAGE 1 OF <br />Project Number: 117-057A M,BE/WBE Participation Goal 7-10%�, <br />L IL <br />Project Name: Ameritech Drive Pavement Improvements <br />0; <br />Bidder: Walsh & K Inc, <br />By: of Asphalt Operations 6/12— <br />John M. Peisker (Title) (Date )�: <br />Md�BE Firm State Barricading, Inc. <br />Owner or Contact at MBE/WBE Firm James Michalski <br />Telephone: 574-,287-2078 Fax: 574-287-1744 Email: statebarricadel@aol,com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Maintaining of traffic and traffic control devices <br />RESULTS OF CONTACT WITH THE MBEIWBE FIRM: <br />Subcontractor will perform, the work <br />MBEAIVBE Firm C, Lee Construction Services, Inc. <br />Owner or Contact at IMBEIWBE Firm Chip Lee <br />Telephone: 219-922-7733 Fax: 219-888-9564 Email: chii�p@cleecsi.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Trucking - Hauling <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Subcontractor wfli perform the work_ <br />Version 10/17/2016 Contractor's Bid for Public Works - 11 <br />