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_.T _ <br />CITY OF SOUTH BEND . . M <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE-2.1 " .1' <br />WBE CONTACTED <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 WBEs. It is the bidder's sole responsibility to verify whether any listed <br />woman -owned business meets the WBE qualifications. Attach additional pages if necessary. OF 1 <br />PAGE <br />Project Number: 123-011 WBE Participation Goal 4.65 <br />Project Name: YSB/South Bend Thrive Subdivision Infrastructure Improvements <br />Bidder: Selge Construction CO., Inc. <br />By: Justin Butler Vice President September 12, 2023 <br />Signature) (Title) (Date) <br />WBE Firm <br />Owner or Contact at WBE Firm <br />Telephone: Fax: Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />**Please see attached list of the South Bend Certified Directory <br />RESULTS OF CONTACT WITH THE WBE FIRM: <br />WBE Firm <br />Owner or Contact at WBE Firm <br />Telephone: Fax: Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE WBE FIRM: <br />Version 09/29/2021 Contractor's Bid for Public Works -18 <br />