5-MBE_Utilization_Form.docx

This is a Minority and Women-Owned Business Enterprise (MBE/WBE) Utilization Documentation form required by the City of New Haven, Connecticut for the Willow & Nicoll Raised Intersection project. The project aims to increase safety and accessibility at the intersection of Willow Street and Nicoll Street through demolition and construction of a raised asphalt intersection, concrete sidewalk, reinforced stamped concrete, curb, bollards, and utility cover adjustments.

The form requires contractors to submit a complete subcontractor listing that includes company name, address, type of work, dollar amount, outreach method used to secure the subcontractor, and appropriate company classification. Contractors must certify achievement of the City of New Haven's 25% minority and women-owned small business participation goal. Submission of the completed form is mandatory; failure to include it will render the bid non-responsive and subject to rejection. The form requires signature and date approval from the relevant City department.