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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE-1.0 jr <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: 123-030 Project Name: `The Hill' TIF Project —Site Work <br />Bidder: Total Bid Amount. ta�Z�. &C,�1 MBE Goal: 2.0% <br />Page { of d <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 />BidlPro oral <br />j 5 rC Cif 5 LOGy 5T1L5 <br />.2z13 5� Ci3r1^.rx—> Avg. <br />70rdTh i3s.v.�iSti YL-Gig/ <br />13Ear ef20 <br />�S7`i�i43-��/ <br />%l L1G.�yst. �,. <br />ov (f,IUC <br />�' � <br />L, I <br />Submitted by: <br />Version 09l29l2021 <br />,4,V Y,�:1 a <br />Print Name Signature <br />Contractor's Bid for Public Works - 8 <br />i <br />