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, <br /> � <br /> ' � City of Decatur, Illinois RETURN WITH BID WHEN <br /> #1 Gary K. Anderson Plaza <br /> � Decatur, IL 62523-1196 REQUIRED <br /> ' <br /> � Minority Business Enterprise <br /> ' Participation �lllaiver Request <br /> ate: Project Title: ' 2016 MANH�LE REHABILITATION PROJECT <br /> ' Project Number: 2016-32 <br /> Prime Contractor. <br /> ' 4ddress: <br /> � <br /> � �'hone: <br /> 1 Contact Person: <br /> �mail: <br /> ' e hereby request that the City waive the Minority Business Enterprise(MBE)participation goals on the above named <br /> roject for the following reason(s). We further affirm that the stated reasons and documents provided are true and <br /> orrect and not misleading. <br /> ' HECK 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) I <br /> ' ❑ No subcontracting opportunities exist. (Attach explanation) I <br /> ❑ The award of subcontract(s)is impracticable. (Attach explanation) <br /> t ❑ Other—(State reason and attach explanation) <br /> � <br /> ' Signature of Prime Contractor Date <br /> t FOR OFFICIAL USE ONLY <br /> ❑ APPROVED ❑ DISAPPROVED <br /> inorit artici ation oals are reduced on this ro'ect for the followin reason s see Article 28-10-7 Ci Code : <br /> , ❑ The project is essentiat for City operations. <br /> ❑ Emergency circumstances require a waiver. <br /> ' ❑ Evidence of a ood faith effort by the contractor. <br /> , ❑ The contractor will self perform all work and will not subcontract any portion of the project. <br /> ' EVIEWED BY: <br /> � <br /> ' � Public Worlcs Director Date <br /> 19 <br /> ' <br />