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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: 119-108 Project Name: Lincoln Way West and Olive Street Intersection Improvements <br />Bidder: Milestone Contractors North, InC. Total Bid Amount: $1,799,100.00 MBE Goal: 2.43% <br />Page 1 of 1 <br />Primary Contact Person Scope of Work to be Performed Dollar Amount of MBE Percentage <br />Name & Address of MBE of Total <br />(Name/Telephone) (Attach scope/schedule if you need additional space) Component o: a n _____i <br />Master Filter Corporation Ronald Orr <br />d/b/a Master Enterprises 317-545-3335 <br />P.O. Box 18523 <br />Indianapolis, IN 46218 <br />MBE materials provided for lighting and signal <br />equipment <br />Submitted by: Dustin P. Hilary, Director of Estimating, <br />Print Name South Bend ignature <br />Version 1/13/2021 Contractor's Bid for Public Works - 10 <br />$48,012.00 1 2.67% <br />5/11/21021 <br />Date <br />4 <br />CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MWBE-1.0 <br />T <br />MWBE UTILIZATION PLAN <br />)a",. _ <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: 119-108 Project Name: Lincoln Way West and Olive Street Intersection Improvements <br />Bidder: Milestone Contractors North, InC. Total Bid Amount: $1,799,100.00 MBE Goal: 2.43% <br />Page 1 of 1 <br />Primary Contact Person Scope of Work to be Performed Dollar Amount of MBE Percentage <br />Name & Address of MBE of Total <br />(Name/Telephone) (Attach scope/schedule if you need additional space) Component o: a n _____i <br />Master Filter Corporation Ronald Orr <br />d/b/a Master Enterprises 317-545-3335 <br />P.O. Box 18523 <br />Indianapolis, IN 46218 <br />MBE materials provided for lighting and signal <br />equipment <br />Submitted by: Dustin P. Hilary, Director of Estimating, <br />Print Name South Bend ignature <br />Version 1/13/2021 Contractor's Bid for Public Works - 10 <br />$48,012.00 1 2.67% <br />5/11/21021 <br />Date <br />