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n <br />CITY OF SOUTH BEND - <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN F <br />FORM MBE -1.0 <br />MBE UTILIZATION PLANf <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-owned business meets the MBE qualifications. <br />Project Number: 121-006A Project Name: (Division 2 — Marion St) COSB 2021 Drainage Improvements <br />Bidder Milestone Contractors North, Inc. Total Bid Amount: $173,920.00 Div 2 MBE Goal: 2.7% <br />Name & Address of MBE Primary Contact Person <br />(Namerrelephone) <br />C. Lee Construction Services, Inc. Frederick "Chip" Lee <br />1011 S. Lake StreetJ 219-922-7733 <br />Gary, IN 46403 <br />Submitted by: <br />Dustin P. Hilary, Director of Estimating <br />Print Name <br />Page 1 of 1 <br />Scope of Work to be Performed Dollar Amount of MBE of Total <br />(Attach scope/schedule if you need additional space) Component Bid/Pro l <br />Hauling <br />$4,700.00 2.7% <br />Version 08/16/2021 Contractor's Bid for Public Works - 12 <br />8/24/2021 <br />Date <br />