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' , <br /> ' � City of Decatur, Illinois RETURN WITH BID WHEN <br /> � - #1 Gary K. Anderson Plaza <br /> Decatur, IL 62523-1196 REQUIRED <br /> ' Minori Business Enter rise <br /> tY P <br /> Participation Waiver Request <br /> , <br /> Date: �U�E � ��� Project Title: � � -U� { �� — ��(J �� , <br /> ' Project Number: �(� _� <br /> Prime Contractor. '�I t.�f�(E� �91•l-r�(La'a('TD(L,S ��.1�, <br /> ' <br /> �c��tia � �rt��r�c�� �zr� <br /> Address: <br /> ' t C�-�`1 t'Y10�,�p ! L l.pc�loU <br /> Phone: �(�1 �c�-�i 3�-a <br /> , Contact Person: ���►f�►�-� L � (I�1�l C`�1 <br /> Email: �LI i�l►'\�-U ��(Z>GC''��JUi �l'���F�, ��-P�' <br /> ' We hereby request to waive all of the Minority Business Enterprise(MBE) participation 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 /> �.�,���V►1, � � - <br /> LO- �S` � � <br /> ' Signature of Prime Contracto Date <br /> FOR OFFICIAL USE ONLY <br /> ' ❑ APPROVED ❑ DISAPPROVED <br /> ' The minorit participation oals are waived on this project for the followin reason(s) (see Article 28-10-7 City Code : <br /> ❑ The project is essential for City operations. <br /> ❑ Emergency circumstances require a waiver. <br /> ' ❑ Evidence of a good faith effort by 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 /> ' Public Works Director Date <br /> ' 20 <br />