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aiurr;, <br />CITY OF SOUTH BEND r <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 />123-048 Project Name <br />Monroe Circle Demolition <br />l r�l�rr'�t'�iLf`=�i I li� ✓ Total Bid Amount: <br />MBE Goal: 1.4% <br />Page of <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?'C%'—K-tcu? <br />(i"_` u�� <br />-7'r <br />Fl-'iRA <br />At <br />4v <br />v � <br />l0 ;MIS <br />Submitted by: <br />Print Name Signature Date <br />Version 09/29/2021 Contractor's Bid for Public Works - 8 <br />