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CITY OF SOUTH SEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE-1.0 <br />MBEfWBE PARTICIPATION <br />This completed form should be supplied with Bids that pertain to City of South Bond Public Works Projects involving MBEIMBE participation, <br />it Is the bidder's sole responsibility to verity whether any listed minority or woman business meats the qualifications of a Minority orWomen's <br />owned business. <br />Project Number.- 118.083B _ Project Name: JC Lauber Site Improvements <br />Bidder Rieth-Riley Construction Co., Inc, Total Bid Amount: 434,961.00 MBE/WBE Goal: n/a <br />Page _l_of 1 <br />Name & Address of MHE085 <br />Primary Contact Person <br />(Namorrelephone) <br />Scope of Work to be Performed <br />(Allach scopa/schedule if you need additional space) <br />Dollar Arnotint of <br />MDEMBE Comnpono I <br />Percentage <br />QfTolat <br />Bid1pro oral <br />State Barricading, Inc. <br />24983 US 20 West <br />South Bend, In. 46619 <br />James M. <br />574-287-2078 <br />MOT <br />$ 5,500.00 <br />I.3°/© <br />Submitted by� Joshua A. MCCormick, Sales Manage�r e" September 20, 2018 <br />Print Name Date <br />Version 1011712017 Contractor's Bid for Public Works - 10 <br />