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,`F�arrr aFt, <br />� G <br />CITY OF SOUTH BEND w a <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />} a <br />FORM WBE-1.0 <br />WBE UTILIZATION PLAN �` Y <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 />121-064A <br />Project Name: Nexus Center Roof Replacement <br />Midland Lngincering Company, Inc. Total Bid Amount: <br />232,600.00 <br />WBE Goal: 2.1% <br />Page of <br />Name & Address of WBE <br />Primary Contact Person <br />Name/Tele hone <br />( p ) <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 TotalBid/Proposal <br />JI -IDM Roofing Company <br />1115 L. 9th Street <br />Indianapolis, IN 46302 <br />Jim Huntington <br />Matetial Supplier <br />4,884.60 <br />2.1% <br />Submitted by: )\Michael W. Frahn, CPA President/CLO /V � �.-� 12/13/22 <br />Print Name Signature Date <br />Version 09/29/2021 Contractor's Bid for Public Works - 11 <br />