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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />i41; <br />0 <br />FORM MWBE-2.1 <br />MBEIWBE CONTACTED <br />This completed form should be supplied with Bids that pertain to City of South Band Public Works Projects <br />requiring contacted IMBE/WBE 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. PAGE I OF <br />- <br />Project Number: 11 5-053A MBE/WBE Participation Goal 6.79% <br />Project Name: ay qgnyersion of Colfax Avenue <br />Bidder: WWshKIII y, In <br />By: (Siena re) Dust in Hilary <br />MBE Firm Jackson Services <br />Owner or Contact at MBE/WBE Firm Pat <br />(Title) <br />Jackson <br />Telephone: 574-542-2871 Fax: 574-542-9214 Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Building demolition and clearing of right of way (tree removal) <br />Manager 4/24 d ............ <br />C <br />(oat�� <br />U <br />4-767� ASP <br />low <br />jacksons@pwrtc.com, !N'D\ <br />1109#111%0" <br />RESULTS OF CONTACT WITH THE MBENVBE FIRM: <br />Subcontractor will be performing the work. <br />MBEIVVBE Firm State Barricadiqg_,inc._ <br />Owner or Contact at MBE/WBE Firm James Michalski <br />Telephone: 574-287-2078 Fax: 574-287-1744 Email': statebarricadel@aol.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Maintaining of traffic and traffic control devices <br />RESULTS OF CONTACT WITH THE MBEMBE FIRM: <br />Subcontractor will be performing the work. <br />Version 10/17/2017 Contractor's Bid for Public Works - 15 <br />