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d <br />CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE -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 />118-0058 Project Name: Riverside Drive Bank Stabilization <br />HRP CONSTRUCTION INC. <br />Total Bid Amount: <br />MBE Goal: 0.3% <br />Page 1 of 1 <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 <br />of Total <br />tl & R Trucking <br />1845 N. Elmer St. <br />South Bend, IN 46628 <br />Ueda Godette <br />(574) 234-1268 <br />Trucking <br />Bid/Proposal <br />$4,0000.00 <br />` ®� <br />Submitted by <br />Matthew D. Cain, President November 23, 2021 <br />Print Name Signature Date <br />Version 09/29/2021 Contractor's Bid for Public Works - 9 <br />