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fff <br />A. <br />CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN Y � <br />FORM MBE -1.0 <br />MBE UTILIZATION PLAN <br />i ms compietea Torm snouia ne 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: 122-028 Project Name: 2022 Street & Se <br />Bidder: EXj ®Y1,�, .� Total Bid Amount: <br />1� A -- <br />Material Bid <br />MBE Goal: N/A <br />Paae of <br />Name &Address of MBE <br />Primary 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 />Submitted by: dj <br />�. <br />Print Name Signa t Date <br />Version 09/29/2021 Contractor's Bid for Public Works - 13 <br />