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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM WBE-1.0 <br />WBE UTILIZATION PLAN <br />Version 9/29/2021 Page - 12 Public Works Quote <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 /> <br /> Project Number: 120-010R Project Name: Walker Field House Restoration Project <br /> Bidder: Page ____ of _____ <br />DIVISION A WBE GOAL: 4.7% <br />Name & Address of WBE <br />Primary Contact <br />Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Dollar Amount of <br />WBE Component <br />Percentage of Total <br />Base Bid <br /> <br /> <br /> DIVISION A WBE TOTALS <br />ALTERNATE #1 WBE GOAL: 4.7% <br /> <br /> <br /> ALTERNATE #1 WBE TOTALS <br />Submitted by: <br /> Print Name Signature Date