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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: 5/21/15 Project Title: Sunset Levee In—Line Check Valve Installati n <br /> Project Number: 2015-13 <br /> Prime Contractor. G.A. Rich & Sons, Inc. <br /> P.O. Box 50 204 South Perry Street <br /> Address: <br /> Deer Creek, IL 61733 <br /> Phone: 309-447-6231 <br /> Contact Person: Brian Rich <br /> Email: brian@garich.com <br /> Subcontractors: <br /> Subcontractor Name MBE or Amount %of Total Scope of Work <br /> Non-MBE Contract <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 utilize -"" "" - Gn}ornricps are to be <br /> used in the execution of this project. Prime Contractors have an oblige s <br /> commitment to increase diversity among the firms working on City con <br /> This form must be completed and submitted with the bid Propose -t shall <br /> be listed in the columns above; along with the total amount to be paid and <br /> scope of work. If for whatever reason the Prime Contractor has to util q/ -nit a <br /> Notification of Change in Participation with the necessary support l <br /> The undersigned certifies that the information included herein is true e greed to <br /> perform the scope of work described. The undersigned further certif i c1' <br /> interest in any of the listed subcontractors. 5 <br /> V)�` Q� <br /> V J <br /> Signature of Prime Contractor <br /> D <br /> 18 <br />