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CITY OF SOUTH SENDalai rir <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 Bond Public Works Projects Invotving MBEIMBE participation. <br />It Is the bidder's sole responsibility to verify whether any listed minority or woman business meets the quallficatic ris of a Minority or Women's <br />owned business. <br />Project Number. 118-306 Project Nams: EAST BANK TRAIL STORM REPAIRS <br />Bidder: Rieth-Riley Const. Co.,Inc. <br />Total Bid Amount: _$ 230,000.00 <br />MBE/WSE Goal: <br />n/a"— <br />Page—i-0-1— <br />Name & Address of MEE-ANH E Primary Conlack PoAson <br />(Name/Talaphono) <br />..... . ....... <br />Sc" of WaA to be Performed <br />(Attach scopaischedule if you nved additional space) <br />Dollar Amount of <br />IMBEAVRE comimilurd <br />Porcantoge <br />Of aw <br />State Barricading James <br />MOT <br />$3,509.00 <br />1.5% <br />South Bend, In. Michalski <br />Submitted by: Ruben Alvarado <br />—a <br />November 12 <br />2019 <br />Prin4—Nz m <br />Signature <br />Date <br />Version 4W2019 Contractor's Bid for Public <br />Works - 9 <br />