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___ ____of Total <br />Percentage <br />of <br />Bid/Proposal <br />icipation. It <br />_______ <br />Page <br />MWBE Goal: <br />ions. <br />Component <br />Date <br />Dollar Amount of MWBE <br />Public Works Quote <br /> <br />INCLUSION PROGRAM PLAN <br />1.0 <br />- <br />Scope of Work to be Performed <br />scope/schedule if you need additional space) <br />Total Bid Amount: <br />(Attach <br />FORM MWBE <br />ITY OF SOUTH BEND <br />Signature <br />C <br />MWBE UTILIZATION PLAN <br />ame: <br /> N <br />Project <br />(Name/Telephone) <br />Primary Contact Person <br />MINORITY AND WOMEN BUSINESS ENTERPRISE <br />ersion 2/14/2020 <br />V <br />Print Name <br />Name & Address of MWBE <br />Project Number:Bidder:Submitted by: <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MWBE partis the bidder’s sole responsibility to verify whether any <br /> listed minority or woman business meets the MWBE qualificat <br /> <br />