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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN - <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: <br />Bidder: <br />123-048 <br />Project Name: <br />Monroe Circle Demolition <br />c_-A-�z"`ri Total Bid Amount: �,. � � � %�: j WBE Goal: 4.7% <br />Page__L_of t' <br />Name & Address of WBE <br />Primary Contact Person <br />Scope of Work to be Performed <br />Dollar Amount of WBE <br />Percentage <br />of Total <br />(Name/Telephone) <br />(Attach scope/schedule if you need additional space) <br />Component <br />Bid/Proposal <br />f <br />-{���`% <br />Z%l-7 <br />Submitted by: MA , &Su�a iIi��1 j��lti�� 5 Z— 3 <br />Print Name ignature Date <br />Version 09/29/2021 Contractor's Bid for Public Works - 9 <br />