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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE-2.1` <br />MBE/WBE CONTACTED so. <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects <br />requiring contacted MBEIWBE to obtain Good Faith Efforts. It is the bidder's sole responsibility to verify <br />whether any listed minority or woman business meets the qualifications of a Minority or Women's owned <br />business. <br />PAGE OF / <br />Project Number: 116-074 MBENVBE Participation Goal 7.1% <br />Project Name: Demolition of Vacant and Abandoned Houses, Phase IX <br />Bidder: Cep <br />- <br />BY re -<-/ T J0— <br />l (Signature) ��"" ((�� (Title) (Date) <br />MBENVBE Firm one ✓ Ot 4-1 <br />Owner or Contact at MBENVBE Firm <br />Telephone: +n,39 4j/ S7fl0'7 Fax: � Email: / �}�,n�/� �/�,�,C/�Gf•SUP��y�j� <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: j <br />/) !Q/) <br />RESULTS OF CONTACT WITH THE MBENVBE FIRM: <br />MBENVBE Firm <br />Owner or Contact at MBENVBE Firm <br />Telephone: Fax Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBENVBE FIRM: <br />Version 7/31/2015 Contractor's Bid for Public Works - 15 <br />