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' �pl'� CH UF' <br />�Y 11? <br />CITY OF SOUTH BEND �' 7' <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MWBE-1.0� <br />MWBE UTILIZATION PLAN ' <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MWBE participation. It <br />is the bidder's sole responsibility to verify whether any listed minority or woman business meets the MWBE qualifications. <br />Project Number: <br />Bidder: <br />119-084B <br />Project Name: Former Salvation Army Building Roof Repairs <br />Midland Engineering Company Inc. Total Bid Amount: <br />MWBE Goal: 2.7% <br />Page of <br />Name & Address of MWBE <br />Primary Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Dollar Amount of MWBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />JHM Roofing Company <br />1115 E. 9th Street <br />Indianapolis, IN 46202 <br />Jim Huntington <br />317-605-2789 <br />Material Supplier <br />$13,203.00 <br />3% <br />Submitted by: Michael W. Frahn, CPA <br />Print Name President/CEO/CFO <br />Signature <br />Version 01/13/2021 Contractor's Bid for Public Works - 8 <br />2/9/21 <br />Date <br />