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CITY OF SOUTH BEND"""'" <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />NY,nMW Y.<. <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 MBE/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. <br />PAGE 2 OF 2 <br />Project Number: 117-031R <br />MBE/WBE Participation Goal Good Faith <br />Project Name: North Station - Well No. 1 Re lacement <br />Bidder: Peerless Midwest, Inc. <br />By: - t idu44 - Project Manager Februar 11 2019 <br />(Signature) (Title) (Date) <br />MBE/WBE Firm Cazares Concrete LLC <br />Owner or Contact at MBE/WBE Firm Francisco Cazares <br />Telephone: 765-649-7159 Fax: Email: francisco@cazaresconcretellc.com <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />Cast in glace concrete structure <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />No response <br />MBE/WBE Firm <br />Owner or Contact at MBE/WBE Firm <br />Telephone: Fax: Email: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBE/WBE FIRM: <br />Version 7/20/201 S Contractor's Bid for Public Works - 10 <br />