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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM' <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 2 <br />Project Number: 119-030 R MBE/WBE Participation Goal <br />Project Name: Commerce Center Architectural Precast Concrete Panels <br />Bidder: High Concrete Group <br />By: Midwest Sales Manager 8/12/19 <br />(Signature) (Title) (Date) <br />MBE/WBE Firm Dalton Protection Inc. <br />Owner or Contact at MBE/WBE Firm Ken Crouse <br />Telephone: 937-219-1718 Fax: 937-849-9134 Email: kcrouse@daltonprojection.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />079200: Joint Sealants <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Not Bidding <br />MBE/WBE Firm Robert Haines Co. <br />Owner or Contact at MBE/WBE Firm Jim Prldgmen <br />................. <br />Telephone: -547-5271jim@roberthainesco.com <br />317-542-0679 Email: jimroberthainesco.com <br />r- <br />............ _ ......... ............... <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />079200: Joint Sealants <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />In ey001501l <br />Version 1/17/2019 Contractor's Bid for Public Works - 12 <br />