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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM WBE-1.0 <br />WBE UTILIZATION PLAN <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: PROJ00000300 Project Name: Coveleski Stadium Field Lighting Installation <br />Bidder: /JI/ a ty>ift? fu.9#t3/ ! 1ia C.Total Bid Amount: {2 q$>' OtfO' !!.E <br />) <br />Primary Contact Person Name & Address of IJ'JBE (Name/Telephone) <br />� � �tV /t , LL C � t 8,.,-,i'.� -:;J7g18'1007 �:lb��� 2 (!)O (p r 7.) ," w_ [°I. s��:Lv v t.rfZ. r �r na V20,t- <br />Submitted by: ,1tlutf.t !2Jw.a:fPrint Name <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />b ·!);�� �cryl/6 <br />,r J.u11.o /:fiGI/(_ > ut51osC<..! cf Spoi (5) <br />&ie,t1,e�( t4-bo-r, <br />Signature <br />Version 09/29/2021 Contractor's Bid for Public Works - 9 <br />WBE Goal: 4.3% ---- <br />Page ( of .____.__{_ <br />Dollar Amount of IJ'JBE Percentage <br />ofTotal Component Bid/Prooosal t 3'(JcJ � '?-9-./.,<J� <br />f /D,31'/-� 3.'-((p V <br />-------------$3000.00 <br />Fixing price typo per phone conversation with contractor.