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City of Decatur, ulinois RETURN WITH BID WHEN <br /> : � #1 Gary K. Anderson Piaza <br /> Decatur, I� 62523-1196 REQUIRED <br /> Minarity Business Enterprise <br /> Participation Waiver Request <br /> Date: �� _(� _ � Project Title: � <br /> � <br /> (v1 ,� ��. �rw�c�,� (��b �l e -� <br /> Project Number. � _� l ��S �'�`� ����C` <br /> �rime Contractor: ---t/\, �-�.-� --- C�C`�C.._..�4���` �� ��,(j1.[ , <br /> i � L:u�l✓t " ' �G` <br /> �ddress: <br /> — �P��:�� � � .��.. ��-��. �2-- <br /> Phone: �--���"" t�j�p� <br /> �antact Persan: �.:7C.�-(� �y(/L�\°�� <br /> mail; G���.�-�l.��✓1.-�-�-e!� '✓�G-� v'✓�. <br /> �e hereby request that the City waive the Minari Business Enter rise MBE rtici ation oals on the above named <br /> tY p � ) p J <br /> project for the following reasan(s). We further affirm that the stated reasons and documents provided are true and <br /> arrect and not misleading. <br /> �HECK ALL'THAT APP�Y. SPECIFIC SU P 1 <br /> P ORT NG DQCUMENTATIQN MUST BE SUBMITTED AS INDICATED. <br /> � An insufficient number of MBEs responded to our invitation ta bid. (Attach a list of MBEs contacted for each work <br /> item to be subcantracted along with the dallar amount far each item} <br /> No subcontracting opportunities exist. {Attach explanatian} <br /> ❑ The award of subcontract(s)is impracticable. (Attach explanation) <br /> ❑ Other—(State reason and attach explanation) <br /> t>sc����- �-�--�--�.`� <br /> 9i ature of Prime Cantractor Dake <br /> FQR t7FFlClAL USE ONLY <br /> ❑ APPROVED ❑ DISAPPROVED <br /> The minori artici atian oals are waived on this ro'eck for the follawin reason s see Article 28-10-7 Cit Code : <br /> ❑ The project is essential for Ci#y aperatians. <br /> ❑ Emergency circumstances require a waiver. <br /> Evidence of a good faith effort by the contractor. <br /> The contractor will self-perform all work and will not subcontract any portian of the project. <br /> ❑ The contractor praposes to meet City MBE goal. No Waiver Required <br /> EVIEWED BY: <br /> �.,..�.—�--�' .��1— ! Z --- J � <br /> Public Works Director Date <br /> � 20 <br />