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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: 121-020 Project Name: 2021 Crack Sealing <br />Bidder: Cornerstone Construction Group LLC Total Bid Amount: $229.928.16 <br />MWBE Goal: N/A <br />Page of <br />Name & Address of MWBE <br />ruf 8fti <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />, <br />CITY OF SOUTH BEND <br />i(� f;V` <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />2021 Crack Sealing <br />FORM MWBE-1.0 <br />100% <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: 121-020 Project Name: 2021 Crack Sealing <br />Bidder: Cornerstone Construction Group LLC Total Bid Amount: $229.928.16 <br />MWBE Goal: N/A <br />Page of <br />Name & Address of MWBE <br />Primary Contact Person <br />Name/Tele hone <br />( p ) <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 />Cornerstone Construction Group LLC <br />Nick Lunn <br />2021 Crack Sealing <br />229,928.16 <br />100% <br />Submitted by: Nick Lunn <br />Print Name <br />Version 2/14/2020 <br />Signature <br />Page - 16 <br />5/25/2021 <br />Date <br />Public Works Quote <br />