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BielderlResponelent will submit <br /> this completed document with <br /> Not Applicable BawllPIropwasal., <br /> F.2: STATEMENT OF INTENT OF MOB/WOB/SECTION 3 UTILIZATION <br /> I, certify that ( ) will / ( ) will not <br /> will utilize Minority Owned Business (MOB) or Women Owned Business (WOB) as subcontractor(s), vendor(s), <br /> supplier(s), or professional service(s). The estimated dollar value of the amount that we plan to pay the MOB or <br /> WOB subcontractor(s), vendor(s), supplier(s), or professional service(s)is$ <br /> Description of Work MOB Race/ WOB Amount Section 3 Name of MOB/WOB/Section 3 <br /> Amount$ Ethnicity $ Amount$ Organization/Address <br /> This certification is a material representation of fact upon which reliance was placed when this transaction was <br /> made or entered into.The City reserves the right to withdraw or terminate the proposed contract should the <br /> representation of fact be false. <br /> Signature and Date: <br /> Printed Name: <br /> Position: <br /> Page 2 of 2 <br />