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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 minority or woman business meets the WBE qualifications. <br />Project Number: 121-037 Project Name: 100 S Michigan Tree Grates <br />Bidder: The Robert Henry Corporation f Total Bid Amount: oZ Y. <br />-- , <br />Name & Address of WBE <br />Ritschard Brothers, Inc. <br />1204 West Sample <br />South Bend, IN 46619 <br />State Barricading <br />24963 US 20 West <br />South Bend, IN 46628 <br />Primary Contact Person <br />(Namerrelephone) <br />Rachelle Dolniak <br />574-288-4777 <br />WBE Goal: 3.7% <br />Page 1 of 1 <br />Scope of Work to be Performed Dollar Amount of WBE Percentage <br />(Attach scopeischedule if you need additional space) Component of Total <br />Bid/Proposal <br />Excavating Site Demo $ 24,450.00 ''Q.� <br />James Michalski Traffic Control <br />574-287-2078 <br />$ 1,965.00 a, s 9 <br />Submitted by: Brian S. Heny, President October 26, 202_1 <br />Print Name Signature 7- Date <br />Version 09/29/2021 Page - 28 Public Works Quote <br />LST`H ems,+, <br />CITY OF SOUTH BENDgwk <br />a <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />x; , ^fa�R _ <br />FORM WBE-1.0 <br />WBE UTILIZATION PLAN <br />els <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 minority or woman business meets the WBE qualifications. <br />Project Number: 121-037 Project Name: 100 S Michigan Tree Grates <br />Bidder: The Robert Henry Corporation f Total Bid Amount: oZ Y. <br />-- , <br />Name & Address of WBE <br />Ritschard Brothers, Inc. <br />1204 West Sample <br />South Bend, IN 46619 <br />State Barricading <br />24963 US 20 West <br />South Bend, IN 46628 <br />Primary Contact Person <br />(Namerrelephone) <br />Rachelle Dolniak <br />574-288-4777 <br />WBE Goal: 3.7% <br />Page 1 of 1 <br />Scope of Work to be Performed Dollar Amount of WBE Percentage <br />(Attach scopeischedule if you need additional space) Component of Total <br />Bid/Proposal <br />Excavating Site Demo $ 24,450.00 ''Q.� <br />James Michalski Traffic Control <br />574-287-2078 <br />$ 1,965.00 a, s 9 <br />Submitted by: Brian S. Heny, President October 26, 202_1 <br />Print Name Signature 7- Date <br />Version 09/29/2021 Page - 28 Public Works Quote <br />