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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MWBE-2.1 <br />MWBE CONTACTED <br />Version 2/14/2020 Page - 19 Public Works Quote <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects <br />requiring Good Faith Efforts to contact MWBEs. It is the bidder’s sole responsibility to verify whether any listed <br />minority or woman business meets the MWBE qualifications. Attach additional pages if necessary. <br />PAGE_______OF________ <br />Project Number: 121-020 MWBE Participation Goal N/A <br />Project Name: 2021 Crack Sealing <br />Bidder: <br />By: <br /> (Signature) (Title) (Date) <br /> <br /> <br />MWBE Firm <br />Owner or Contact at MWBE Firm <br />Telephone: Fax: Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br /> <br /> <br /> <br /> <br />RESULTS OF CONTACT WITH THE MWBE FIRM: <br /> <br /> <br /> <br /> <br /> <br /> <br />MWBE Firm <br />Owner or Contact at MWBE Firm <br />Telephone: Fax: Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br /> <br /> <br /> <br /> <br />RESULTS OF CONTACT WITH THE MWBE FIRM: <br /> <br /> <br /> <br /> <br />