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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <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 />PAGE OF <br />Project Number: 118-070 <br />Project Nanme:018 Street Paving <br />Wa <br />Bidder: a Kelly, Inc. <br />By: <br />Firm, Traffic Control S <br />MBENVBE Participation GoaI 7% <br />Cb' <br />�yORIU41- <br />VP of South Bend Area 8/9/18 <br />(Title) (Date) <br />% <br />ialists, Inc. <br />Owner or Contact at IVIBEMBE Firm Tracey Triska F614010% <br />Telephone: 574-772-7001 Fax: Email: tracewo-,ftsspecialists. net <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Pavement Markings <br />RESULTS OF CONTACT WITH THE IVIBE1WBE FIRM: <br />Subcontractor was entered into our bid. <br />MBE/WBE Firm C. Lee Construction Services, Inc. <br />Owner or Contact at MBE/WBE Firm Chip Lee <br />Telephone: 219-922-7733 Fax: 219-888-9564 Ernail': chip@cleecsi.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Hauling - HMA & Millings <br />RESULTS OF CONTACT WITH THE IVIBEMBE FIRM: <br />Subcontractor was entered into our bid. <br />Version 10/17/2017 Contractor's Bid for Public Works - 10 <br />