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CITY OF SOUTH BEND` <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE•1.0 <br />MBE9'WBE PARTICIPATION <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Pro,iocts Involving MBEIMBE participation. <br />It Is the bidder's sole responsibility to verity whether any listed minority or woman business meets the qualifications of a Minority of Women's <br />owned business. <br />Project Number: 118.0101B Project Name. Historic Leeer Park Improvements- Btd Package 2 �m m <br />Bidder: Rieth-Riley Const. Co., InC, Total Bid Amount: $ 1,642,800.00 MFJENVBEGoaL 7 _...._ <br />Page 1 of 1 <br />Name 6 Address of MBEM/BE - Prif percernage <br />(Namerrelsphoneary Contact )on mm �(lUtoch sc pa/sc adulscope of e if you need additional space) MBto be Parlarmed E/W13ollar E Compoowt onent „ u B at Total <br />State Barricading Mary Michalski Maintenance of Traffic $ 7,800.00 .05% <br />24983 US 20 West 574-287-2078 <br />South Bend, In. 46619 <br />Joshua A. McCormick <br />Submitted by: _ _ 201 , 22 r b Octoe9 <br />. .22..201..a... <br />PrintNeme 5itgntai4�r ��� Date <br />Version 111712019 Contractors Bid for Pubh( .48 <br />