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M1' <br />CITY OF SOUTH BEND_-. <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: 123-048 Project Name: Monroe Circle Demolition <br />Bidder: Green Demolition Contractors, Inc Total Bid Amount: $851.600.00 <br />Name & Address of MBE <br />Trucks R Us - Kennedy <br />Expressline <br />23300 IN-23 <br />Submitted by: Jason Bennett <br />Print Name <br />Primary Contact Person <br />(Name/relephone) <br />K. Johnson <br />574-340-8471 <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Trucking & Hauling <br />MBE Goal: 1.4% <br />Page 1 of 1 <br />Dollar AmounLaL IBE Der ntage' <br />Component of Total <br />$23,419.00 1 2.75% <br />.. -� 23-May-2023 <br />Signaturel Date <br />Version 09/29/2021 Contractor's Bid for Public Works - 8 <br />