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City of Decatur, Illinois RETURN WITH BID WHEN REQUIRED <br /> #1 Gary K. Anderson Plaza <br /> Decatur, IL 62523-1196 Minority Business Enterprise <br /> Participation Waiver Request <br /> Date: 3 46 Project Title: <br /> Project Number: <br /> Prime Contractor: ���p_ /}n�*� ►,� d1� I 'v�� Ejeef y;c 6t fJ e<'c.-4-4 <br /> Address: <br /> ll CLQ-+ TL <br /> l <br /> Phone: Q t? 4 a 3 - a S cl � <br /> Contact Person: <br /> Email: (ood ,,e M'- ,' ( Conn <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) I/ <br /> Q No subcontracting opportunities exist. (Attach explanation) W,(( <br /> ❑ The award of subcontract(s) is impracticable. (Attach explanation) <br /> ignature of Prime Contractor Date <br /> FOR OFFICIAL USE ONLY <br /> u` `�Pryv APPROVED ❑ DISAPPROVED <br /> � vlrt' <br /> The minority participation goals are waived on this project for the following reasons 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 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 /> Page 1 of 1 <br />