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� , , <br /> City of Decatur, Illinois RETURN WITH BID <br />� 1 '``""� <br /> #1 Gary K. Anderson Plaza <br /> Decatur, IL 62523-1196 Subcontractor Utilization Statement <br /> , Date: , � � ProjectTitle: U�.tD L� � K.[�� " �' <br /> O 20 � l�o �N?a�- P� �T R�r�,S���t�c� <br /> Project Number: G� � P�� �L.� 2 0 (7 O� <br />, ' <br /> Prime Contractor: �( I��(,7 , � L� �I�j/k v1�.fl� (�.�tl/LPlkft.11,� <br />'� , I S <br /> Address: - � Z � ' lV� G� ��L� <br />� � Z 22 <br /> ' Phone: Z�� �Z�' ��� <br /> ' Contact Person: �,�-'� �, �c��'� <br /> Email: ��.�J � �L/t../t.Lp, (�yr1 <br /> , Subcontractors: <br /> Subcontractor Name MBE or Amount %of Total Scope of Work <br /> Non-MBE Contract <br /> ' llll-1 L��s�. I�fhlLA�7tI? S��f�'� � ,�.b- �2�?9 2•l� '��.a� �. P�1/huc,'�'T AiI.R-�KlN6f <br /> ' <br /> , <br /> ' <br /> ' Totals 2�7�L�l� J'�.a� �� <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 tisted 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 /> interest in any of the listed subcontr ctors. <br /> ' , / <br /> �8• 2g� � S <br /> Signature of Prime Contractor Date <br /> ' I�.F��ba�'j � �JJnl1�, �!'�c� P���� <br /> is <br />