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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 />121-048B <br />Milestone Contractors <br />South Bend Neighborhood Infrastructure Project — Longfellow Avenue and <br />Project Name: South Street Intersection <br />Jorth, Inc. Total Bid Amount: $475,500.00 MBE Goal: 2.79% <br />Page 1 of 1 <br />Name & Address of MBE <br />Primary Contact Person i Scope of Work to be Performed <br />(Name/Telephone) (Attach scope/schedule if you need additional space) <br />CITY OF SOUTH BEND' <br />Percentage <br />of Total <br />Bid/Proposal <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN`-.-{ <br />Bernard Coutee <br />574-993-0071 <br />FORM MBE -1.0 <br />$13,300..00 <br />MBE UTILIZATION PLAN <br />- <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 />121-048B <br />Milestone Contractors <br />South Bend Neighborhood Infrastructure Project — Longfellow Avenue and <br />Project Name: South Street Intersection <br />Jorth, Inc. Total Bid Amount: $475,500.00 MBE Goal: 2.79% <br />Page 1 of 1 <br />Name & Address of MBE <br />Primary Contact Person i Scope of Work to be Performed <br />(Name/Telephone) (Attach scope/schedule if you need additional space) <br />Dollar Amount of MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />1st Class Log isitics, LLC <br />24423 IN 23 <br />South Bend, IN 46614 <br />Bernard Coutee <br />574-993-0071 <br />Hauling <br />$13,300..00 <br />2.80% <br />Submitted by: Dustin P. Hilary, Director of E_stimati <br />Print Name <br />Version 09/29/2021 Contractor's Bid for Public Works - 9 <br />11/22/2022 <br />Date <br />