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r City of Decatur, Illinois RETURN WITH BID <br /> #1 Gary K. Anderson Plaza <br /> Decatur, IL 62523-1196 Minority Business Enterprise (MBE) <br /> Utilization Statement <br /> Date: Project Title: (. <br /> Total Contract Value- Project Number. <br /> Section I: Prime Contractor Information <br /> Prime Contractor: u t c:(i�r�� �0 1'i'>I' �ti'L, I �� <br /> �� <br /> i i - Vi1 1 � � k qtr <br /> Address: <br /> Phone: <br /> Contact Person: <br /> Email: ___] Cv� t: (G✓ ���L(i;Lj G� Iur,l��i_ n L'y�i 1 <br /> Section II: Selected Subcontractors <br /> Subcontractor Name MBE or Amount %of Total Scope of Work <br /> Non-MBE Contract <br /> (JD t# 20,000 <br /> �C:a�,�;t L_�.�.c_" �?1C (�;C4�i i�20b,o0( <br /> C-o, (kfl<;i oe-, fLi( I` q3 no,000 oCG <br /> f <br /> 2Ci" C <br /> �0 <br /> Totals <br /> • If more subcontractors are utilized,please copy this form and attach the additional information. <br /> Section III: Purchase of Goods,Materials,or E ui ment <br /> Minority Business Enterprise Name Amount % of Total Scope of Work <br /> Contract <br /> Totals <br /> • If more firms were contacted,please copy this form and attach the additional information. <br /> Section IV: MBE subcontractors that submitted bids but were not selected <br /> 22 <br />