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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM XACX I. <br />FORM MWBE-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 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 1 OF <br />Project Number: 118-072 <br />MBE/WBE Participation Goal <br />Project Name: McKinley Avenue and Fremont Park Improvements <br />Bidder: H N S T PEW <br />By:tderrt t 11 n <br />( Lure) M a t t h e w �DC,�in��(T?itlree)� (Date) <br />MBE/WBE Firm SEE ATTACHED <br />Owner or Contact at MBEANBE Firm <br />Telephone: <br />Fax: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />MBE/WBE Firm <br />Owner or Contact at MBE/WBE Firm <br />Telephone: <br />Fax: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Email: <br />Email: <br />Version 7/20/2018 Contractor's Bid for Public Works - 12 <br />