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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE DIVERSITY <br />DEVELOPMENT PROGRAM <br />FORM MWBE-1.0 <br />MBE PARTICIPATION <br />Version 4/2/2019 Contractor’s Bid for Public Works - 9 <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It <br />is the bidder’s sole responsibility to verify whether any listed minority or woman business meets the qualifications of a Minority owned <br />business. <br />Project Number: 120-044 Project Name: Ignition Park: EV Charging Park <br />Bidder: Total Bid Amount: MBE Goal: <br />Page_______of___ ____ <br />Name & Address of MBE/WBE 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 <br />MBE/WBE Component <br />Percentage <br />of Total <br />Bid/Proposal <br />Submitted by: <br />Print Name Signature Date <br />2.4%R. Yoder Construction, Inc. <br />03-09-2021Brad Yoder <br />$416,158.00