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RETURN OF THIS FORM WITH YOUR BID IS PREFERRED BID# <br />MINORITY (MBE)/WOMEN (WBE) BUSINESS PARTICIPATION <br />By Executive Order dated December 10, 1987, Governor Romer established a goal of <br />17% for minority participation in the State's business. Vendors, suppliers and <br />contractors doing business with the State of Colorado are encouraged to solicit <br />quotations for supplies and services, where needed to perform work on a State contract, <br />from minority- and women-owned businesses. <br />The Division of Minerals and Geology has need to track the extent of participation with <br />minority- and women-owned businesses. Please help us by answering the following <br />questions. The answers to these questions will not be used to determine the winning <br />offer for this Bid. Response to these questions is not mandatory for your bid to be <br />considered. However, response is a condition of award and will be necessary prior to <br />issuance of a purchase order or contract. <br />1. Is your firm minority-owned? Yes_ , No <br />2. Is your firm woman-owned? Yes_ , No <br />3. If your is not aminority- or woman-owned firm, please indicate what <br />percent of the products or services you will be providing to the State, <br />should you be the winning bidder, you will be acquiring from: <br />•minority-owned subcontractors and/or suppliers % <br />•woman-owned subcontractors and/or suppliers % <br />Please list below the names of these firms and the estimated value of the business you <br />intend to conduct with them. <br />NAMES OF MBE/WBE FIRMS <br />TOTAL AMOUNT <br />DOLLAR AMOUNTS <br />Company Name: <br />By: <br />Name <br />c: \wp51\spea\mbewbatrtn <br />