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Docusign Envelope ID: E74COCFE-CO64-4OD2-A75B-E107999569F8 <br />BidderlRespondent will submit <br />this completed document with <br />Bid/Proposal. <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 />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 />Page 32 of 43 <br />