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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />2 <br />FORM MWBE-1.0 <br />M Br -JWBF I PARTICIPATIONIris <br />This completed form should be supplied with Bids that pertain to City of South Bond Public Works Projects Involving MBEJMBE participation. <br />It Is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Wornen's <br />owned business. <br />Project Number: 118-067 _ Project Name: 11 Berlin Place - Sits Concretel Landscape Plantinas, and Bldg,. 4 Roof Pavers" <br />Bidder, Rieth-Riley Const, Co, Total Bid Amount: <br />meEtwep- coal: n/a <br />Nuffm & Addrou of YGEAVU <br />I'mm ContW Berson <br />(N-WT&Wph—) <br />t oafft* lo bo PwMmwd <br />(Aft*O JC0WSd)"A% 0 you need *d~49 speed) <br />Dales Amunt of <br />MaEMBF convolwt <br />C9 pww" <br />TOW <br />no MBEANBE <br />bids received <br />Submitted by: Nashua. McCormick June 12, 2018 <br />Print Name Slone Date <br />version 101117=11 Conhactoes Bid for Public Works - 10 <br />