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^THE <br />d `- <br />CITY OF SOUTH BEND ld <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 MBE participation. It is <br />the bidder's sole responsibility to verify whether any listed minority or woman business meets the MBE qualifications. <br />Project Number: 120-044R Project Name: Ignition Park: EV ChargincLpark <br />Bidder: Milestone Contractors North, Inc. <br />Name & Address of MBE Primary Contact Person <br />(Name/Telephone) <br />C. Lee Construction Services, Inc. Frederick "Chip" Lee <br />1011 S. Lake Street <br />Gary, IN 46403 219-888-9554 <br />Submitted by: <br />Dustin Hilary <br />Print Name <br />Total Bid Amount: $349 0�0 <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Hauling <br />Version 01/13/2021 Contractor's Bid for Public Works -10 <br />MBE Goal: 2.4% <br />Page 1 of 1 <br />Dollar Amount of MBE of Total <br />Component Q,,,,p��„� <br />$8,400.00 1 2.4% <br />4/13/2021 <br />Date <br />