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City of Decatur, Illinois RETURN WITH <br /> ' #1 Gary K. Anderson Plaza <br /> Decatur, IL 62523-1196 BID <br /> ' Subcontractor Utilization Statement <br /> Date: June 17, 2015 Project Title: 2015 Trenchless Long Lining RE pairs <br /> ' Project Number: 2015-28 <br /> ' Prime Contractor: SAK Construction, LLC <br /> 864 Hoff Road <br /> Address: <br /> ' O'Fallon, MO 63366 <br /> Phone: (636)385-1000 <br /> ' Contact Person: Boyd Hirtz,Vice President <br /> Email: bhirtz@sakcon.com <br /> ' Subcontractors: <br /> Subcontractor Name MBE or Amount %of Total <br /> Non-MBE Contract Scope of Work <br /> A4),-M9E 32, 434.E $,TV% Gl y/ v� P t 1�ps <br /> 1 <br /> 1 <br /> 1 <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% Minors y 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 d sprib d. The undersigned further certifies that it has no controlling, dominating, or conflict of <br /> interest in an the listed u o tra�tors. <br /> ' <br /> June 17, 2015 <br /> Boyd Hirtz,Vice,Pr&dent Sig atur f Prime Co r for Date <br /> 18 <br />