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,..�_._. <br /> City of Decatur, Illinois RETURN WITH BID <br /> #1 Gary K. Anderson Plaza <br /> Decatur, IL 62523-1196 �ubcontrac�or Utili�atiran 5tatement <br /> �ate: Project Title: <br /> Total Contract Valus: Project Number: <br /> Section I: Prime Gontractor Information <br /> Prime Contractor: <br /> Address: <br /> Phone: <br /> Cantact Person: <br /> Email: <br /> Sec#ion It: Selected Subcontractars <br /> Subcontractor Name MBE or �mount °1�o€To#a! Scope af Wark <br /> Non-MBE Contract <br /> Tatals <br /> « If more subcontractors are utilized, piease capy this form and attach the additianai informatian. <br /> Section til. MBE subcontractars that submitted bids but were not selected <br /> Subccsntractar Name Scope of Vitork Bid Reason for I}enial <br /> Page 1 af 2 <br />