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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 />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects requiring <br />Good Faith Efforts to contact MWBEs. It is the bidder's sole responsibility to verify whether any listed minority or <br />woman business meets the MWBE qualifications. Attach additional pages If necessary. <br />PAGE 1 OF 1 <br />Project Number: 121-019 MWBE Participation Goal 5.7% <br />Project Name: Brick Pavement,Sppt Repaic 2021 <br />Bidder: Selge Construction Co., Inc. <br />By: _ j Robert Kuhns. Project Engineer July 13, 2021 <br />(Signature) (Title) (Date) <br />MWBE Firm State Barricading, Inc. <br />Owner or Contact at MWBE Firm Mary Michalski <br />Telephone: 574-287-2078 Fax: 574-287-1744 Email: Statebarricade1@aol.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT. <br />Traffic Control <br />RESULTS OF CONTACT WITH THE MWBE FIRM: <br />Bid Accepted <br />MWBE Firm <br />Owner or Contact at MWBE Firm <br />Telephone: Fax: Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MWBE FIRM: <br />Version 2/14/2020 Page - 30 Public Works Quote <br />