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�SnV a"dP <br />CITY OF SOUTH BEND r " <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />r <br />DEVELOPMENT PROGRAM <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 />Project Number: <br />Project Name: <br />Bidder: <br />By: <br />(Signature <br />MBE/WBE Firm <br />PAGE OF <br />118-094R MBE/WBE Participation Goal <br />Morris Theater Plaster Repairs <br />Gibson -Lewis, LLC <br />President <br />Robert it' Ll`n eonlelter (Title) <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 MBEIWBE FIRM: <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 4/2/2019 Contractor's Bid for Public Works -10 <br />11/26/19 <br />(Date) <br />