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' , . <br /> ' Cit of Decatur, Illinois <br /> � #1 Gary K. Anderson Plaza RETURN WITH <br /> Decatur, IL 62523-1196 BID <br /> ' Subcontractor Utilization Statement <br /> Date: ���C �+ Project Title: i ���� . � � __� <br /> ' Project Number: � _ U <br /> ' Prime Contractor: ��(Iti.�l`fL� ��Tr�(���5 �►JC,. <br /> Address: — <br /> i��3ya C �t'do�m�,c � <br /> ' ��� n�Oti�r� lL �aS�U <br /> Phone: _ �_l_1__ac�-�i �v�r_� o� <br /> ' Contact Person: � I 1,L1�� L ��-I t�(►,1�-1 <br /> Email: - IC.I�'1�1�►� �(�C�C�17uiIG,�f.►'1�F�' <br /> , Subcontractors: <br /> Subcontractor Name MBE or Amount % of Total Scope of Work <br /> ' Non-MBE Contract <br /> ' <br /> , <br /> � <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 /> intere t i ny of the listed subcontractors. <br /> � �'. � � � �� ►� <br /> 1 " ' ` �h <br /> Signature of Prime Contract Date <br /> , 19 <br />