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CITY OF SOUTH BEND p <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE-1.0 <br />MBE UTILIZATION PLAN <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 />121-006B <br />Project Name: SOUTH BEND 2021 DRAINGE IMPROVEMENTS — BID B DIVISION II CHAPIN ST <br />Selge Construction Co., Inc. Total Bid Amount: $ 230.698.75 MBE Goal: 2.4% <br />Page 1 of 1 <br />Name & Address of MBE <br />Primary Contact Person <br />(Name/Telephone) <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Dollar Amount of MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />1 st Class Logistics <br />2213 St. Charles Ave <br />South Bend, IN 46614 <br />Bernard Coutee <br />574-993-0071 <br />Hauling <br />** Please see attached letter <br />$ 968.00 <br />0.42% <br />Submitted by: <br />Justin Butler, Vice President <br />Print Name <br />May 9, 2023 <br />Si mature Date <br />Version 09/29/2021 Contractor's Bid for Public Works -12 <br />