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' <br /> � Cit of Decatur, Illinois <br /> ' � �' � #1 Gary K. Anderson Plaza RETURN WITH BID WHEN <br /> `� Decatur, IL 62523-1196 REQUIRED <br /> ' Minority Business Enterprise <br /> Participation Waiver Request <br /> ' �ate: September 9, 2016 Project Title: 2016 MANHOLE REHABILITATION PROJECT <br /> ' Project Number: 2016-32 <br /> Prime Contractor: Culy Contracting, Inc. <br /> ' Address: 5 Industrial Park Drive <br /> Winchester, IN 47394 <br /> ' Phone: 765-584-8509 <br /> ' Contact Person: Ben Price <br /> Emai�: benp@culycontacting.com <br /> ' We hereby request that the City waive the Minority Business Enterprise(MBE) participation goals on the above named <br /> project for the following reason(s). We further affirm that the stated reasons and documents provided are true and <br /> 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 /> ' ❑ Other—(State reason and attach explanation) <br /> Y,_._ � <br /> � ` � ✓ �,� September 22, 2016 <br /> Signa re of P ontr tor Date <br /> , FOR OFFICIAL USE ONLY <br /> ❑ APPROVED ❑ DISAPPROVED <br /> ' Minorit participation oals are reduced on this pro'ect for the followin reason(s) (see Article 28-10-7 Ci 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 /> ' � The contractor will self perform all work and will not subcontract any portion of the project. <br /> REVIEWED BY: -�, ��I <br /> /; , <br /> ' �, Z� � Z� � � <br /> Public Works Director Date <br /> 19 <br /> ' <br />