Laserfiche WebLink
CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE-1.0 <br />MBE/WBE PARTICIPATION <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving <br />It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications <br />owned business. <br />Project Number: 117-120A <br />Bidder: <br />Name & Address of MBE/WBE <br />Submitted by: <br />Print Name <br />Project Name: Mishawaka Ave. Traffic Signals at Fire Station No. 9 <br />Total Bid Amount: <br />Primary Contact Person <br />(Namelfelephone) <br />Njo <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />�M <br />Signature <br />Version 7/20/2018 Contractor's Bid for Public Works - 10 117-120A <br />P <br />Dc <br />MBE/ <br />9 <br />Date <br />