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City of Decatur, Illinois RETURN WITH BID <br /> #1 Gary K. Anderson Plaza <br /> Decatur, IL 62523-1196 Subcontractor Utilization Statement <br /> Date: s_ Project Title: <br /> Project Number: G <br /> Prime Contractor: ���-er CG��/ �✓� . <br /> Address: Iv � � `&, V,� <br /> Phone: <br /> Contact Person: -ems �VX4C%- <br /> Email: G`r J,(-e-re— <br /> Subcontractors: <br /> Subcontractor Name MBE or Amount %of Total Scope of Work <br /> Non-MBE Contract <br /> t� A <br /> Totals <br /> • If more subcontractors are utilized, please copy this form and attach the additional information. <br /> The City of Decatur is committed to promoting minority participation in public works construction projects and in accordance with <br /> Article 28-10 of the City Code, has established the subcontractor utilization goal of 10% Minority Business Enterprises are to be <br /> used in the execution of this project. Prime Contractors have an obligation to make a good faith effort to advance the City's <br /> commitment to increase diversity among the firms working on City construction projects. <br /> This form must be completed and submitted with the bid proposal. All subcontractors intended for use on this project shall <br /> be listed in the columns above; along with the total amount to be paid to the subcontractors; percentage of total contract; and <br /> scope of work. If for whatever reason the Prime Contractor has to utilize a subcontractor not listed above, they must submit a <br /> Notification of Change in Participation with the necessary support documentation. <br /> The undersigned certifies that the information included herein is true and correct; the subcontractors listed above have agreed to <br /> perform the scope of work described. The undersigned further certifies that it has no controlling, dominating, or conflict of <br /> p p 9 9� 9� <br /> interest in any of thq listed subcont ctors. <br /> Signature of Prime Contractor Date <br /> 18 <br />