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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 a minority- 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 DOLLAR AMOUNTS <br /> TOTAL AMOUNT <br /> Company Name: <br /> By: <br /> Name <br /> c:\wp51\specs\mbewbe.frm <br /> II <br />