Pursuant to the Consolidated City of Indianapolis146 Instructions To Bidders Section 93 and Part 6 this application for a check one or both of the following MBE WBE VBE DOBE program waiver is hereby s ID: 877120
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1 Application for MBE/WBE/VBE/DOBE Program
Application for MBE/WBE/VBE/DOBE Program Waiver Pursuant to the Consolidated City of Indianapolis’ Instructions To Bidders Section 9.3 and Part 6, this application for a (check one or both of the following) MBE WBE VBE DOBE program waiver is hereby submitted Dateof Application:ProjectNumber: ProjectName: Bidder: Contact name:Phone: Address: If Bidder did not attend all such meetings, pleaseexplain: Bidder placed the following advertisements in search of prospective MBEs/WBEs/VBEs and DOBEs for the contract. (List and attach all suchadvertisements.) PUBLICATIONDATE If Bidder placed no such advertisements, pleaseexplain: Bidder provided the following written notifications to MBEs/WBEs/VBEs/DOBEs notifying them of MBE/WBE/VBE/DOBE OR Bidder made the following efforts to select portions of the work to be performed by MBE/WBE/VBEs/DOBEs in order toincrease the likelihood of achieving the stated goals, including the Bidder contacted and/or negotiated with the following MBEs/WBEs/VBEs/DOBEs for specific subbids and/or partnerships. Please include a description of the information provided to MBE/WBE/VBEs/DOBEs regarding the plans and specifications for portions of the work to be performed and a statement of why prospective agreements with MBE/WBE/VBEs/DOBEs were not reached. (List and attach documentation of suchcontacts/negotiations.)
2 CONTACTADDRESSPHONE INFO.PROVIDEDWHY NE
CONTACTADDRESSPHONE INFO.PROVIDEDWHY NEGOTIATIONSFAILED (Use additional sheets if needed.)Bidder provided the following technical assistance to MBEs/WBEs/VBEs/DOBEs in an effort to obtain MBE/WBE/VBE/DOBE participation, such as obtaining bonding, insurance, or a needed line of credit for the project, in an effort to obtain MBE/WBE/VBE/DOBE participation. (Attach documentation of such assistance.)Bidder researched other possible areas of participation, including but not limited to, suppliers, shipping or transport enterprises, engineering enterprises or any other role that may contribute to the production and delivery of the product or services specified in the contract (Attach documentation of such efforts.) Following is a description of any other efforts Bidder made to meet the MBE/WBE/VBE/DOBE participation goal. (Attach documentation of suchefforts.) Bidder certifies that all information contained herein and attached hereto is true and accurate and that all good faith efforts were made by Bidder for the purpose of fulfilling the project goals. Bidder’sSignature:te: For Minority Business Development Program use only. This Application for Program Waiver is:Not ApprovedApproved Approved subject to the followingconditions/restrictions: _____________________________________________Camille Blunt, DirectorOffice of Minority & Women Business Development