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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM WBE-1.0 <br />WBE CONTACTED <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 woman -owned business meets the WBE qualifications. <br />Project Number: 120-014 Project Name: Potawatomi Zoo Parking Lot <br />Bidder: °°►' Page of <br />BASE BID WBE GOAL: 5.0% <br />Name & Address of WBE <br />Primary Contact Person <br />(Name/Telephone)]{jj <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Dollar Amount of <br />WBE Component <br />Percentage of Total <br />Base Bid <br />�f M p� T {(''� ,{� y <br />Sr1V 1 h;1 fY ( S ` L11 � ' i i � +�3..� 11'i / � <br />� c^� C �-py'i�S [ <br />�]/ <br />Fr "moi. / a .iC �f 4 <br />(�{ � �' • <br />tom'' . <br />Z <br />�1J-Ny'L e <br />G� eGC �a(2jg 4yy <br />i-:rLre_` Y-i..P'9e CAeAr <br />r_ ,J, •�s� <br />� <br />� P t� <br />�i <br />•]'''�L I 'p� / <br />�p1 <br />1f WSL' sI • 4 i V/ G.�L V <br />/ls_� <br />4. � �� <br />//$ _ . � <br />Lel„fJ t �� <br />/f <br />iil(.3 US t:�fG(�°�.����--�c� <br />;�. %ZGTZ <br />i#�,iF �:.-�= 1 �`c <br />C C,> <br />f 4 <br />\•((1 r - (fes .,r�pz a� <br />�d` u&,& f? Ge -f -ea i +1'6°4pd� L ,_'l.L <br />"\�k(� j k{ <br />Vv -(d vVS�',4 ^'��' <br />,ray <br />s a C NJ T99 Lf -5 <br />BASE BID WBE TOTALS <br />1 <br />Y <br />ALTERNATE #1 WBE GOAL: 4.3% <br />Name & Address of WBE <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 <br />WBE Component <br />Percentage of Total <br />Alternate #1 Bid <br />//)a rr° iC,`` <br />C i <br />{ t1'�s.�.� vj3'J <br />• E V <br />�'- +.12.L9 <br />f- :v. <br />ALTERNATE #1 WBE TOTALS <br />Version 10/28/21 Contractor's Bid for Public Works - 13 <br />