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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 />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 />123-019 <br />Project Name: 2023 Street & Sewer Material Bid <br />Total Bid Amount: <br />WBE Goal: NIA <br />Page. <br />Name & Address of WBE <br />Primary Contact Person <br />(Name[Telephone) <br />Scope of Work to be Performed <br />(Attach scopelscheduie if you need additional space) <br />Dollar Amount of WBE <br />Component <br />Percentage <br />of Total <br />BidtPro osal <br />Submitted by: <br />Print Name Signature <br />Version 09/29/2021 Contractor's Bid for Public Works - 15 <br />Date <br />