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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: 120-014 <br />Project Name: Potawatomi Zoo Parking Lot <br />o LJ Bidder: t <br />a <br />BASE BID MBE GOAL: 2.5% <br />Page I of <br />Name & Address of MBE <br />w <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Dollar Amount of MBE <br />Component <br />CITY OF SOUTH BEND <br />t�z 3 r G�'(ij 1 i1�2 <br />c <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />�`r✓1. rsi - <br />FORM MBE -1.0 <br />ZLB <br />C <br />IrA) qU(R i{ q <br />"xaTM, <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: 120-014 <br />Project Name: Potawatomi Zoo Parking Lot <br />o LJ Bidder: t <br />a <br />BASE BID MBE GOAL: 2.5% <br />Page I of <br />Name & Address of MBE <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 MBE <br />Component <br />Percentage of Total <br />Base Bid <br />t�z 3 r G�'(ij 1 i1�2 <br />c <br />g4 <br />5;7c( 3 l.f*../ ( <br />�`r✓1. rsi - <br />t cc <br />ZLB <br />C <br />IrA) qU(R i{ q <br />-S.s1. <br />j <br />ALTERNATE #1 MBE TOTALS; <br />BASE BID MBE TOTALS <br />JI <br />o <br />ALTERNATE #1 MBE GOAL: 1.5% <br />Name & Address of MBE <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 MBE <br />Component <br />Percentage of Total <br />Alternate #1 Bid <br />� <br />41-S ir.0 %{{ "S <br />!� <br />�`r✓1. rsi - <br />j <br />[� L� a „s'�'y <br />D <br />-S.s1. <br />j <br />ALTERNATE #1 MBE TOTALS; <br />Version 10/28/21 Contractor's Bid for Public Works - 11 <br />