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CITY OF SOUTH BENDA'ora, <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY r <br />DEVELOPMENT PROGRAM <br />FORM MWBE-2.1 <br />MBEMBE CONTACTED 'V <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 2 <br />Project Number: 119-030 MBE/WBE Participation Goal <br />Project Name: Commerce Center Mixed Used Development — Arch. Precast Conc. Panels <br />Bidder: Coreslab Structures (Indianapolis) Inc, <br />By. U74x, 13AAzt1l Corey Greika, Vice President/ Sales Manager 5/28/19 <br />(Signature) (Title) (Date) <br />MBE/WBE Firm eic ii-F ii atached <br />Owner or Contact at MBENVBE Firm <br />Telephone: Fax: Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />MBENVBE Firm <br />Owner or Contact at MBEIWBE Firm <br />Telephone: Fax: Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Version 1/17/2019 Contractor's Bid for Public Works - 12 <br />