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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE-2.1 <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 verity whether any listed <br />woman -owned business meets the WBE qualifications. Attach additional pages if necessary. <br />PAGE 1 OF <br />Project Number: 123-014 WBE Participation Goal 4.65% <br />Project Name: Demolition of 1000 West Sample Street <br />Bidder: 17 TlhD roup, Inc. <br />By. , Jy erald Blomberg President 02/13/2024 <br />(Signature) ( I me) (Date) <br />WBE Firm Jack Gray Transport, Inc <br />Owner or Contact at WBE Firm John <br />Telephone: 219-938-7020 Fax: Email: Info@jackgrey.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Trucking and transportation of fill needed to backfill basement upon completion of <br />demolition activities. <br />RESULTS OF CONTACT WITH THE WBE FIRM: <br />This firm appears to meet all required qualifications needed and has the resources to fulfill the <br />project needs. <br />WBE Firm Jewel Constracting, LLC <br />Owner or Contact at WBE Firm Peri <br />Telephone: 574-400-9194 Fax: Email: peri@jewelcontractingllc.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT <br />Topsoil, seeding and site resoration neede to provide final stabilization upon completion of <br />basement backfill operations. <br />RESULTS OF CONTACT WITH THE WBE FIRM: <br />Firm is qualified and has tentatively agreed to preform thework on this project. <br />Version 07/19/2023 Contractor's Bid for Public Works - 15 <br />