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y�C"N4kl AdN . <br />CITY OF SOUTH BEND, <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY `50 <br />DEVELOPMENT PROGRAMy;` <br />FORM MWBE-1.0 <br />MBE/WBE PARTICIPATION <br />I"#rois Cora N rt+3fl farm should be Supplied vuith Bids that pertain to City of South Bernd Public Works Projects Gvolvinq MBEIMBE particiPatiOn. <br />It is the bidders sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's <br />owned business. <br />Project Number: <br />119.064 m Project Name: <br />" 316 & 319 W. Jefferson Exterior Renovations ......m.___� <br />....�.. <br />Bidder: <br />�_..._ ...� <br />. Total Bid Amount: N/A <br />MBEMBE Goal: <br />Page of <br />.. ....� <br />Primary Contact Person <br />Name & Address of MBEM/BE (Na(Name/Telephone) <br />Scope of Work to be <br />(Attach scopels,�hO ule if you need additional additional space) <br />Percentage <br />E <br />MBE IM/B lar Amount of Component � Bid/Proposal,,, <br />by: <br />ve 12lCiS <br />Submitted <br />.� <br />me <br />i�.._ ......� <br />^alone„ <br />Date <br />Print N <br />Version 4/2/2019 <br />Contractor's Bid for Public Works - 10 <br />