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CITY OF SOUTH BEND st `p1Te eFrl <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE-1.0 <br />MBEIWBE PARTICIPATION <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE/MBE participation. <br />It is the bidder's sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority or Women's <br />owned business. <br />Project Number: 11"05A Project Name: North Shore Drive Bank Stabilization <br />Bidder: The Stanger Group, Inc. Total Bid Amount: $255, 2,20 00 MBE1WBE Goal: $0.00 <br />Page 1 of 1 <br />Name& Address of MBEMBE <br />Primary Contact Person <br />(Name/relephone) <br />Scope of Work to be Performed <br />co <br />(Attach spe/schetlule if you need additional space) <br />Dollar Amount of <br />MBENJBE Component <br />Percentage <br />of Total <br />Bid/Prosal <br />State Barricade <br />Garrett - Sales <br />Material, labor and equipment for traffic control <br />$3,724.00 <br />1.5% <br />V&R Trucking, Inc. <br />Veda Godette - <br />owner <br />Trucking <br />No response to <br />bid request <br />n/a <br />Submitted by: Colby Stanger -L 12/08/2020 <br />Print Name Signature Date <br />Version 01/29/2020 Contractors Bid for Public Works -8 <br />