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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE-2.1 <br />MBEIWBE 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 1 <br />Pinhook Park Pavilion <br />Project Number: I rove t MBE/WBE Participation Goal 0% <br />Project Name: 118-077B <br />Bidder: Michiana Contracting Inc <br />By: <br />President <br />11/26/19 <br />(Signature) 9 (Title) (Date) <br />MBE/WBE Firm <br />Owner or Contact at MBE/WBE Firm <br />Telephone: <br />Fax: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />MBE/WBE Firm <br />Owner or Contact at MBE/WBE Firm <br />Telephone: <br />Fax: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Email: <br />Email: <br />Version 4/2/2019 Contractor's Bid for Public Works - 10 <br />