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y,g41 �,,Mr <br />CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY ",4 <br />DEVELOPMENT PROGRAM,�C <br />FORM MWBE-2.1 <br />MBE/WBE CONTACTED ""'o <br />This completed form should be supplied 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 meets the qualifications of a Minority or Women's owned <br />business. <br />Project Number: 118-043R <br />PAGE 1 OF 1 <br />MBE/WBE Participation Goal <br />Project Name: VPA Restroom Remodeling <br />Bidder: Larson Danielson Construction Co., Inc. <br />By. X Timothy F. Larson, President 12/20/18 <br />(Signature) (Title) (Date) <br />MBE/WBE Firm NOTE: SEE ATTACHED GRADEBEAM CALL SHEETS & <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 MBE/WBE 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 MBE/WBE FIRM: <br />