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City of Decatur, Illinois RETURN WITH BID WHEN <br /> #1 Gary K. Anderson Plaza <br /> Decatur, IL 62523-1196 REQUIRED <br /> Minority Business Enterprise (MBE) <br /> Participation Waiver Request <br /> Date: September 22, 2021 Project Title: 2021 Manhole Rehabilitation Project <br /> Project Number: 2021-14 <br /> ' Prime Contractor: CulY 9 Contractin LLC <br /> Address: 5 Industrial Park Drive <br /> Winchester, IN 47394 <br /> Phone: 765-584-8509 <br /> Contact Person: Jacob Hart <br /> Email: jacob.hart@culycontracting.com <br /> We hereby request that the City waive the Minority Business Enterprise(MBE) 10% participation goal on the above <br /> named project for the following reason(s) and affirm that the stated reasons and documents provided are true and <br /> correct and not misleading. We further agree this waiver request does not waive the goal that 18% of the total hours <br /> worked should be performed by minority workers as per City Code Chapter 28,Article 10. <br /> CHECK ALL THAT APPLY. SPECIFIC SUPPORTING DOCUMENTATION MUST BE SUBMITTED AS INDICATED. <br /> ❑ An insufficient number of MBEs responded to our invitation to bid on services or materials. (Attach a list of MBEs <br /> contacted for each work item to be subcontracted along with the dollar amount for each item) <br /> XNo subcontracting or purchase of goods, materials or equipment opportunities exist. (Attach explanation) <br /> ❑ The award of subcontract(s) or purchase of goods, materials or equipment is impracticable. (Attach explanation) <br /> I ❑ Other—(State reason and attach explanation) <br /> ❑ I meet or exceed the 10% goal for the use of MBEs (detail is provided on the MBE Utilization Statement) <br /> September 22, 2021 <br /> Signature of Prime Contra for Date <br /> FOR OFFICIAL USE ONLY <br /> ❑ APPROVED ❑ DISAPPROVED <br /> The minority participation goals are waived on this project for the following reasons see Article 28-10-7 City Code): <br /> ❑ The project is essential for City operations. <br /> ❑ Emergency circumstances require a waiver. <br /> Evidence of a good faith effort bv the contractor. <br /> The contractor will self-perform all work and will not subcontract any portion of thereject. <br /> ❑ The contractor proposes to meet City MBE goal. No Waiver Required <br /> REVIEWED BY: <br /> September 22, 2021 <br /> Public Works Director Date <br /> ' 21 <br />