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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: <br />Bidder: <br />122-030 <br />Project Name: Studebaker Museum Roof <br />Slatile Roofing & Sheet Metal Co., Inc. Total Bid Amount: 232,812.00 <br />rs <br />WBE Goal: 2.1% <br />Page of <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 WBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />JHM Roofing Company, Inc <br />1215 E. 9th Street <br />Indianapolis, IN 46202 <br />Jerilyn Huntington <br />317-605-2789 <br />Furnish Roofing Materials: Bonding Adhesive <br />$17,496.00 <br />7 <br />Submitted by: edZr4 1—D rzt <br />Print Name i ure <br />Version 09/29/2021 Contractor's Bid for Public Works - 9 <br />June14, 2022 <br />Date <br />