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<br /> <br /> <br />of Total <br />___ ____ <br />Percentage <br />of <br />Bid/Proposal <br /> <br /> <br /> <br />_______ <br /> <br /> <br /> <br /> <br />Page <br />MWBE Goal: <br /> <br />Component <br />Date <br />Dollar Amount of MWBE <br />Public Works Quote <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />INCLUSION PROGRAM PLAN <br /> <br />) <br /> <br /> <br /> <br />1.0 <br />- <br />17 <br />- <br />Scope of Work to be Performed Page <br /> <br />UTILIZATION PLAN <br />2020 River Lights <br />(Total Bid Amount: <br />(Attach scope/schedule if you need additional space) <br />FORM MWBE <br />ITY OF SOUTH BEND <br />Signature <br /> <br />C <br />MWBE <br /> <br /> <br /> <br />Project Name: <br /> <br /> <br />) <br />(Name/Telephone) <br />Primary Contact Person <br /> <br />supplied with Bids that pertain to City of South Bend Public Works Projects involving MWBE participation. It <br /> <br /> <br />PROJ00000177 <br />( <br />MINORITY AND WOMEN BUSINESS ENTERPRISE <br />ersion 2/14/2020 <br />V <br />Print Name <br /> <br /> <br /> <br /> <br /> <br />Name & Address of MWBE <br />Project Number:Bidder: Submitted by: <br />This completed form should be is the bidder’s sole responsibility to verify whether any listed minority or woman business meets the MWBE qualifications. <br /> <br />