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' �� <br /> � ~ City of Decatur, Iliinois RETURN WITH BID WHEN <br /> t � #1 Gary K. Anderson Plaza <br /> Decatur, IL 62523-1196 REQUIRED <br /> , Minority Business Enterprise <br /> Participation Waiver Request <br /> Date: - � �� ProjectTitle: ���� � ��`�-�-,�- � ���� � -T <br /> r �x�� � <br /> Project Number: � `` <br /> Ol�-C�� <br /> Prime Contractor: — V1..��-�f' -�����--V C���' C T �� <br /> Address: <br /> � t� :���� �. � _ -� <br /> ��-�...��- � � � <br /> ' Phone: � —� � <br /> Contact Person: �Ck-�-L� G�l�`��C�--'-�� <br /> , ` . <br /> EmaiL C `.��.4.1 �,,.�t� \---C�,�� __ � �Vlc�.� C,�';�,, <br /> ' We hereby request to waive all of the Minority Business Enterprise (MBE) pa ipation goals on the above named <br /> project for the following reason(s). The firm further affirms that the stated reasons and documents provided are true <br /> and correct and not misleading. <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. (Attach a list of MBEs contacted for each work <br /> item to be subcontracted along with the dollar amount for each item) <br /> No subcontracting opportunities exist. (Attach explanation) <br /> The award of subcontract(s) is impracticable. (Attach explanation) <br /> ^ % � <br /> ��—,2-�—� � <br /> ' Signature o P e Contr r Date <br /> FOR OFFICIAL USE ONLY <br /> ❑ APPROVED ❑ DISAPPROVED <br /> ' The minori artici ation oals are waived on this ro'ect for the followin reason s see Article 28-10-7 Cit Code : <br /> ❑ The project is essential for City operations. <br /> ' ❑ Emergency circumstances require a waiver. <br /> ❑ Evidence of a ood faith effort b the contractor. <br /> ' � Evidence the contractor received no proposals or inquiries from qualified MBE or firms that employ minority workers <br /> in response to a good faith effort to secure participation. <br /> REVIEWED BY: <br /> ' G�����-L..� � ��"� ��� <br /> Public Works Dire or Date <br /> , 22 <br />