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o��rni RFti <br />CITY OF SOUTH BEND o <br />c <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE-2.1 <br />MBE CONTACTED <br />This completed form should be supplied with Bids that pertaln to City of South Bend Public Works Projects <br />requiring Good Faith Efforts to contact MBEs. It Is the bidder's sole responsibility to verify whether any listed <br />minority or woman business meets the MBE qualifications. Attach additional pages If necessary. <br />PAGE OF <br />Project Number: 122-060B MBE Participation Goal 4.3% <br />Project Name: <br />Bidder <br />Century Center Parking Lot Seal and Stripe <br />By: <br />(Signature) (Title) (Date) <br />MBE Firm <br />Owner or Contact at MBE Firm <br />Telephone: Fax: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />MBE Firm <br />Owner or Contact at MBE Firm <br />Telephone: Fax: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBE FIRM: <br />Version 06/01/2022 <br />Email: <br />Email: <br />Page - 28 Public Works Quote <br />Scanned With CamScanner <br />