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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN' <br />FORM MBE -1.0 <br />:± <br />MBE UTILIZATION PLAN�,:,G;,'T„- <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 />121 -048A -R <br />South Bend Neighborhood Infrastructure Project — Riverside Drive and Leland <br />Project Name: Avenue Intersection <br />Rieth-Riley Construction Co., Inc. Total Bid Amount: J� ?3Z 000.00 MBE Goal: 3.2% <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 />Bid/Proposal <br />1s¢ Cloiss Lojas-hC Ss LU. <br />.2a13 Sf• ck&45 /4vc• <br />Sb,,fl, 6w IN yGGjy <br />btenaeal Covk� <br />57q.99'3. 0071 <br />nick,,,- <br />�� 9,0D <br />3.g% <br />Submitted by: UAAAAk /'e On <br />Print Name 8ibnature <br />Version 09/29/2021 Contractor's Bid for Public Works - 9 <br />10/11/22 <br />Date <br />