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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY" <br />DEVELOPMENT PROGRAM x "' <br />FORM MWBE-2.1 <br />MBE/WBE 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 Cti <br />Pro" "INtaber 119-079 MBE/WBE Participation Goal <br />roject IVare:. �1 erool(ior�"I� <br />(Sire) (Title) <br />(Date) <br />MBENVBE Firm "� ,42Lw �y-)�� <br />Owner or Contact at MBENVBE Firm e-: a n -, <br />Telephone: Q I ga,(�3p Fax: <br />TYPE OF WORK SOLICITED FOR THIS PROJECT: <br />RESULTS OF CONTACT WITH THE MBENVBE FIRM: <br />vv` <br />MBENVBE Firm < <br />Owner or Contact at MBENVBE Firm <br />Email: A ` <br />Telephone: ��74-.340'SL(-2DFax: ............. Email: lYy1 tr �1/Z <br />TYPE OF WORK SOLICITED FOR THIS PROJECT;. <br />RESULTS OF CONTACT WITH THE MBENVBE FIRM.. <br />-TA� &e. , ( 1 <br />Version 4/2/2019 Contractor's Bid for Public Works - 12 <br />