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CITY OF SOUTH BEND <br />MINORITY AND WOMEN.:SUSINES&ENTERPRISE•DIVERSITY F <br />DEVELOPMENT -PROGRAM <br />, a <br />FORM :MWBE-2.1 <br />MBEIWBE CONTACTED <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 />PACE 1 OF 1 <br />Project Number: 117-027 MBENVBE Participation Goal _ <br />Project Name: Farmington Lift Station 14A Rehabilitation _ <br />Bidder: J cher Sewer & Excavating Contractor <br />By; John W. Boettcher, President November 14, 2017 <br />igna (Title) (Date) <br />MBE/WBE Firm State Barricading, Inc. <br />Owner or Contactat MBE/WBE Firm gill <br />Telephone: 574-287-2078 Fax: 57 -287-1744 Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: Traffic Control <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: Using them as a subcontractor <br />MBEIWBE Firm <br />Owner or Contact at MBE WBE Firm <br />Telephone: Fax: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBEIWBE FIRM: <br />Email: <br />Version 8/22/2017 Contractor's Bid for Public Works -11 <br />