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CITY OF SOUTH BEND `- <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN Y <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: 121-OO6B Project Name: SOUTH BEND 2021 DRAINGE IMPROVEMENTS — BID B DIVISION I BEALE ST <br />Bidder: Milestone Contractors North Inc. Total Bid Amount: $198,000.00 WBE Goal: 4.7% <br />Page 1 of 1 <br />Primary Contact Person Scope of Work to be Performed Dollar Amount of WBE Percentage <br />Name & Address of WBE (Name/Telephone) (Attach scope/schedule if you need additional space) Component of Total <br />Bid/Proposal <br />State Barricading, Inc. James Michalski Maintaining of Traffic <br />24963 US Hwy 20 W. 574-287-2078 <br />South Bend, IN 46628 <br />Submitted by: Dustin P. Hilary, Director of Estimating <br />Print Name <br />Version 09/29/2021 Contractor's Bid for Public Works -11 <br />$10,246.00 1 5.17% <br />5/9/2023 <br />Date <br />