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CITY OF SOUTH BEND <br />U <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />1S <br />FORM WBE-1.0 <br />WBE 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 woman -owned business meets the WBE qualifications. <br />Project Number: 121-006A Project Name: (Division 1 — Kaley St) COSB 2021 Drainage Improvements <br />Bidder: Milestone Contractors North, Inc. Total Bid Amount: $94,280.00 Div. 1 WBE Goal: 5.4% <br />Page 1 of 1 <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 />State Barricading, Inc. <br />24963 US 20 W <br />James Michalski <br />574-287-2078 <br />Traffic Control <br />$1,996.00 <br />2.11% <br />South Bend, IN 46628 <br />Slusser's Green Thumb, Inc. <br />125 Montgomery Street <br />Logansport, IN 46947 <br />Carolyn Slusser <br />574-722-3102 <br />Seed, Sod & Turf Blanket <br />$6,665.50 <br />7,07% <br />Submitted by: Dustin P. Hilary, Director of Estimating <br />Print Name <br />Version 08/16/2021 Contractor's Bid for Public Works -11 <br />8/24/2021 <br />Date <br />