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ERM EnviroClean-Rock Mt. , In, <br /> RETURN OF THIS FORM WITH YOUR BID IS PREFERRED BID# PKA-6-3 7 6 <br /> MINORITY (MBEWWOMEN (WBE) BUSINESS PARTICIPATION <br /> By Executive Order dated December 10, 1987, Governor Romer established a goal of 17% <br /> for minority participation in the State's business. Vendors, suppliers and contractors doing <br /> business with the State of Colorado are encouraged to solicit quotations for supplies and <br /> services, where needed to perform work on a State contract, from minority- and women- <br /> 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 offer <br /> for this Bid. Response to these questions is not mandatory for your bid to be considered. <br /> However, response is a condition of award and will be necessary prior to issuance of a <br /> purchase order or contract. <br /> 1. Is your firm minority-owned? Yes , No X <br /> 2. Is your firm woman-owned? Yes , No X <br /> 3. If your is not a minority- or woman-owned firm, please indicate what percent <br /> of the products or services you will be providing to the State, should you be <br /> the winning bidder, you will be acquiring from: <br /> *minority-owned subcontractors and/or suppliers 0 % <br /> •woman-owned subcontractors and/or suppliers 0 % <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 MBEIWBE FIRMS DOLLAR AMOUNTS <br /> N/A N/A <br /> TOTAL AMOUNT N/A <br /> Com ny a M EnviroClean-Rocky Mountain, Inc. <br /> Y: <br /> Daniel S. Hinds, President <br /> Name <br /> cAwp51\specs bewbe.frm <br />