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CITY OF SOUTH BEND <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 WBE participation. It is <br />the bidder's sole responsibility to verify whether any listed minority or woman business meets the WBE qualifications. <br />Project Number: 120-063 Project Name: 905-907-909 Michigan Demolition <br />Bidder: �,, c�'�n �ce..r �'�. /► Total Bid Amount: ac: O, 61-0 WBE Goal: 4.7% <br />Page of <br />Name & Address of WBE <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 WBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />�J CiG/ � h 1S 4wV L3� •Y /� <br />Submitted by: J t (ark, 0"i1'r , P . .;; <br />Print Name <br />Signature <br />Version 01/13/2021 Contractor's Bid for Public Works - 9 <br />