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City of Decatur, Illinois RETURN WITH BID FOR EACH MBE <br /> 111,7 #1 GaryK. Anderson Plaza SUBCONTRACTOR OR SUPPLIER <br /> Decatur, IL 62523-1196 Minority Business Enterprise (MBE) <br /> Information Form <br /> SOUTH TAYLORVILLE ROAD WATER MAIN <br /> Date: 3/5/26 Project Title: REPLACEMENT PROJECT <br /> Total Contract Value: Project Number: 2024-16 <br /> Section I: Minority Business Enterprise (MBE)Information <br /> IName: Agile Procurement & Consulting Services, LLC dba Agile Supply Company <br /> Address: <br /> 4108 Fieldstone Rd, Suite C, Champaign, IL 61822 <br /> Phone: 217-729-2686 <br /> IContact Person: Bryan Banks <br /> Email: bryan.banks@agilesupplycompany.com <br /> Section II: Description of Services or Materials to be Provided <br /> Description of Scope of Services Agreed Upon Estimated Amount Estimated %of <br /> Total Contract <br /> Pipe & Fittings Base Bid $755,662.00 28.0% <br /> IPipe & Fittings Alt 1 $179,769.00 <br /> 1 Pipe & Fittings Alt 2 $85,756.00 <br /> This form must be completed and submitted with the bid proposal for each MBE. All MBEs intended for use on this <br /> project shall have an MBE Information Form signed by the prime contractor and MBE. If for whatever reason the Prime <br /> Contractor changes or adds an MBE, a Notification of Change in Participation Form and MBE Information Form with the <br /> necessary support documentation must be submitted and approved. <br /> 1 The undersigned certifies that the information included herein is true and correct and the MBE subcontractor or material supplier <br /> has agreed to the scope of services described. The undersigned further certifies that this form is not a Contract between the <br /> I City, Prime Contractor or Subcontractor/Material Supplier. <br /> Pri Contractor Si nature Print <br /> Justin Weidner <br /> Title Date <br /> President 3/5/26 <br /> Minority Business Enterprise Signature Print <br /> Bryan Banks <br /> tle Date <br /> President 03-05-2026 <br />