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<br />e <br /> <br />e <br /> <br />~ . <br /> <br />MINORITY AND WOMEN BUSINESS ENTERPRISES <br />PARTICIPATION REPORT FORM <br />MIWBE-1 <br /> <br />Project No. <br /> <br />Project Title: <br /> <br />Date: <br /> <br />College, Institution or Agency <br /> <br />Principal Representative <br /> <br />$ <br /> <br />MBE: Yes 0 WBE: Yes 0 <br />No 0 No 0 <br /> <br />Architect or Contractor <br /> <br />Total Contract <br />Amount <br /> <br />17 % ~ <br />MBE% Goal <br /> <br />23.8% <br /> <br />WBE % Goal <br /> <br />;N~m~'~~ 1m'd r~ss< of; tvJiWBe ':""'1'!1~~:... .......,,::E:w~J;::.. ... <br />:';;~;I1tf~f'~ .,., ......,...,...,..~rp'r~~;,:},':~::_I':L:',;li1~i~ <br /> <br /> <br />*Indicate ethnicity based on Paragraph III. A. above. <br />Total MBE Contracts: <br />Total WBE Contracts: <br />Total MBE %: <br />Total WBE %: <br /> <br />$ <br />$ <br /> <br />SIGNATURES: <br /> <br />Principal Representative <br /> <br />Architect or Contractor <br /> <br />Authorized Representative <br /> <br />Authorized Represl?ntative <br />