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CITY OF SOUTH BEND >` <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN r -,- <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 />122-001 Project Name: 2022 Curb and Sidewalk Construction — Round 1 <br />P9F_ 1Su.ry (0AC4eTE 5ER✓lc6gTotal Bid Amount: 39 34 IoBS� <br />Division 1 — WBE Goal: 5.0% <br />Division 1 Bid Amount: PO 8,TD <br />2 pages <br />Name &Address of WBE <br />Primary Contact Person <br />Scope of Work to be Performed <br />Dollar Amount of WBE <br />Percentage <br />of Total <br />(Name/Telephone) <br />(Attach scope/schedule if you need additional space)Component <br />Bid/Proposal <br />Division 2 — WBE Goal: 5.0% <br />Division 2 Bid Amount: No &_zQ <br />Name &Address of WBE <br />Primary Contact Person <br />(Name(relephone) <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 />Version 09/29/2021 Contractor's Bid for Public Works - 14 <br />