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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 />121-0480 <br />South Bend Neighborhood Infrastructure Project — Ford Street and Walnut <br />Project Name: Street Intersection <br />Rieth-Riley Construction Total Bid Amount: $565,111.23 MBE Goal: 2.69% <br />Page 1 of 1 <br />Primary Contact Person <br />Scope of Work to be Performed <br />�✓ <br />IN <br />CITY OF SOUTH BEND <br />its/\ <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />w <br />FORM MBE -1.0 <br />Bid/Proposal <br />MBE UTILIZATION PLAN <br />Tanner Leibovitz <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 />121-0480 <br />South Bend Neighborhood Infrastructure Project — Ford Street and Walnut <br />Project Name: Street Intersection <br />Rieth-Riley Construction Total Bid Amount: $565,111.23 MBE Goal: 2.69% <br />Page 1 of 1 <br />Submitted by: Garrett VanPWs 11/21/2022 <br />Print Name Signature Date <br />Version 09/29/2021 Contractor's Bid for Publiic Works - 9 <br />Primary Contact Person <br />Scope of Work to be Performed <br />Dollar Amount of MBE <br />P r entage <br />Name <br />& Address of MBE <br />(Name/Telephone) <br />(Attach scope/schedule if you need additional space) <br />Component <br />Bid/Proposal <br />JBL Signal and Lighting <br />Tanner Leibovitz <br />Sign Assembly, and Sign Removal/placement <br />$8,200 <br />1.45% <br />316 Technology Dr. South Bend, IN <br />574-855-2251 <br />6628 <br />1 st Class Logistics LLC <br />Bernard Coutee <br />Trucking <br />$7,500 <br />1.32% <br />213 ST CHARLES AVE SOUTH BEND, <br />574-993-0071 <br />IN 46614 <br />Submitted by: Garrett VanPWs 11/21/2022 <br />Print Name Signature Date <br />Version 09/29/2021 Contractor's Bid for Publiic Works - 9 <br />