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e° °� City of Decatur, Illinois RETURN WITH BID WHEN REQUIRED <br /> ; rF #1 Gary K. Anderson Plaza <br /> '<iNo�S'. Decatur, IL 62523-1196 <br /> Minority Business Enterprise (MBE) <br /> Participation Waiver Request <br /> Date: /,;";3/t.. Lt,.( Project Title: !r'�� I j v(', w u( 1 <br /> I t �<<rttiJt� vCJ ,G�> L.c(c.riJN7 <br /> Project Number: /71)2_262t) -p I <br /> Prime Contractor: (t, . 'S,, , I ii6e I . <br /> r ccr ecl ,'c.erl(pvt:i/ L L C <br /> Address: lt'/{,5 • 'i25 /�.��G� A . <br /> 1 <br /> 7lt,C4/t,)11-C:i IL- 6/7c'.':, <br /> Phone: 3 7) �ci"L-L /2 7 <br /> Contact Person: <br /> Email: . <br /> D; 4<<1 Cc CLEF-P/ cep A-tda,t <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 /> ❑ No 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 /> '❑ Other—(State reason and attach explanation) .01e Ct"flL, ' y�, atr. rYt c,(1 <br /> El I meet or exceed the 10%goal for the use of MBEs(detail is provided on the MBE Utilization Statement) <br /> ( 141cZi2(. <br /> Signature f P' Contractor I / Date <br /> FOR OFFICIAL USE ONLY <br /> ❑ APPROVED ❑ DISAPPROVED <br /> The minority participation goals are waived on this project for the following reason(s)(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 by the contractor. <br /> ❑ The contractor will self-perform all work and will not subcontract any portion of the project. <br /> ❑ The contractor proposes to meet City MBE goal. No Waiver Required <br /> REVIEWED BY: <br /> Public Works Director Date <br /> Rev 08/2020 <br />