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CITY OF SOUTH BENDc�ar,rp <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY r, <br />DEVELOPMENT PROGRAM r�,�ie <br />FORM MWBE-2.1.. rip <br />r � pro <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 />Project Number: 119-018 <br />PAGE OF <br />MBEANBE Participation Goal 7.1 % <br />Project Name: St. Joseph Backwater Valves <br />Bidder: Sel a Construction Co.._ Inc. <br />. ............. <br />BY (Signature) -�� �t K s �Prodect Engineer 12/10�19 <br />Robert m <br />(Title) (Date) <br />MBE/WBE Firm State Barricading, Inc. <br />Owner or Contact at MBE/WBE Firm Mary <br />Telephone: 574-287-2078 Fax: 574-287-1744 Email: statebarricadel@aol.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Traffics�trol_ <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM:. <br />Quoted <br />MBE/WBE Firm BUC Construction Supply, Inc. <br />Owner or Contact at MBE/WBE Firm Teresa Butler <br />Telephone:765-412-3283 Fax: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Quoted <br />Email: tc@bucconstructionsupply.com <br />Version 1/17/2019 Contractor's Bid for Public Works - 10 <br />