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<br />I E~ <br />.. .,;;- \', ,', <br /> <br />. ' <br />,J <br />t . <br /> <br />- <br /> <br />- <br /> <br />Project No. <br /> <br />MINORITY AND WOMEN BUSINESS ENTERPRISES <br />PARTICIPATION REPORT <br /> <br />~\o G",,,,,olcL I U ppca.r Celo ,.,.Lo <br />Project Title: ~\ V Cl.~ "1:>, \J Go r ~ i 0 ^ Date:~ <br />S~ y ~ \"""Q. ~"'''f&''~''''1 <br />C.\AJc..lS . \ <br />Institution or Agency <br /> <br />0\5501' /)..SSoc...\~S <br />ArchitecVEngineer/Consultant or Contractor <br /> <br />Principal Representative <br /> <br />MBE: Yes 0 WBE: Yes 0 <br />No . No . <br /> <br />Total Contract Amount: $ SO , ,,~ <br /> <br />Name and Address of M/WBE . MBE WBE Type of Work <br />Subcontractors and/or Suppliers and/or .. Contract Contract <br />Self-Performed Work by M/WBE Primes. Amounts Amounts <br />'^'. r ~ ~ "eel... c:Lo I\G.. ., ^- "'~....: ..~ <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 />- <br /> <br />-- <br /> <br />- <br /> <br />- <br /> <br />SIGNATURES: <br /> <br />prin~~ ('6 <br /> <br />ArchitecVEngineer/Consultant or Contractor <br /> <br />Authorized Representative <br /> <br /> <br />MWBE-1 <br />(09/2004). <br />