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„tis x�?jait�i: <br /> City of Decatur, TURN <br /> Cfl WITH BID FOR EACH <br /> 41 Gary K. Anderson Plaza <br /> Decatur/ �IL 62523-1196 8LVpqMBE SUBC.C'?� TRACTOR <br /> 4.,�✓ 4iPiO.CPYtID <br /> MBE Subcontractor Information Fors-it <br /> Date: 08/15/2023 Project Title: _ 2023 Local Motor Fuel Tax - — <br /> Total Contract Value. I Project Number. Cif��# 2023-2.5 <br /> t � ---- --- -------- ------ - <br /> Soction I: MBE Subcontractor Information <br /> Subcontractor. Marenco Enterprises 2-PJ <br />' Address: 3490 Leghorn Rd. __—��CA' -�^-� ----.---- <br /> Clinton, li 61727T C"yc[ il �r ..--� /1- J <br />' Phone: (217) 693-2484 -----_- <br /> Contact Person: Mirna Willoughby _ <br /> Email: -rnirna.marenco.ent@Clmail.com <br /> Section ll: Estimated Work <br /> Description of Scope of Work Agreed Upon Estimates! Amount Eszsmatasi 4, <br /> excavating, Equipment & Trucking $20,500.00 <br /> i <br /> i <br /> This form ntiust tae�:r�mpleted and submitted with the,bis! proposal for each IMBE Subcontracxor. ,ill Subcontractors <br /> intended for use on this project shall have an MBE Subcontractor Information Form signed by the K rig??e contractor Manu <br /> subcontractor. If for whatever reason the Prime Contractor changes or adds a Subcontractor, a Notification of ChFango in <br /> ' Participation Form and MBE Subcontractor Information Form with the necessary support documentation roust be suW'i`. <br /> and approved. <br /> The undersigned certifies that the information Included herein is true and correct and the subcontractor has agreed to pE,60 - <br /> the scope of work described. The undersigned further certifies that this form is not a Contract between the City, Prime <br /> Contractor or Subcontractor. <br /> Prime Contractor$i+gnafurQ 4 Print <br /> _ -- <br /> Lrj-._ .�____..-___ <br /> ---�� <br /> _ Subcontractor Si nat!L'�) <br /> Mirna Willcugi-,by_�. - <br /> /Title Date- <br /> President <br /> ate'resident �- <br /> �- 2,02.3_ <br />