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a <br />CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE4.0 <br />MBE 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: 121-037 Project Name: 100 S Michigan Tree Grates <br />Bidder: The Robert Henry Corporation Total Bid Amount:'] <br />Name & Address of MBE Primary Contact Person <br />(Namorrelephone) <br />1st Class Logistics, LLC <br />2213 St. Charles Ave. <br />South Bend, IN 46614 <br />Bernard Coutee <br />574-993-0071 <br />Submitted by: Brian S. Henry, President <br />Print Name <br />Scope of Work to be Performed <br />(Attach scope/schedule If you need additional space) <br />Trucking <br />MBE Goal: 1.6% <br />Page 1 of 1 <br />Dollar Amount of MBE Percentage <br />Component of Total <br />Bid/Pro osal <br />$ 2,464.00 3-a5;%6' <br />r <br />i�'j ��� � <br />" ` _ October 26, 2021 <br />Signature Date <br />Version 09/29/2021 Page - 27 Public Works Quote <br />