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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MWBE-1.0 <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-owned business meets the MBE qualifications. <br />Project Number: <br />Bidder: <br />120-026 Project Name: Airport Annexation Area Water Main Extension <br />HRP CONSTRUCTION INC. Total Bid Amount: <br />MBE Goal: 1.55% <br />Page 1 of <br />Name &Address of MBE <br />Primary <br />Prima Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />P <br />(Attach scope/schedule if you need additional space) <br />Dollar Amount of MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />C.Lee Construction Svc. <br />Frederick Lee <br />1011 S Lake St <br />Gary, IN 46403 <br />(219) 888-9554 <br />Trucking <br />�j O Do -0o <br />1% <br />V & R Trucking <br />Ueda Godette <br />1845 N. Elmer St <br />South Bend, IN 46628 <br />(574) 234-1268 <br />Trucking <br />f <br />Submitted by: Matthew D. Cain, President <br />Print Name gnature <br />Version 08/25/2021 CONTRACTOR'S BID FOR PUBLIC WORK - 8 <br />November 9, 2021 <br />Date <br />