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it <br />CITY OF SOUTH BEND x <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN FORM WBE-1.0 r <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 />Name & Address of WBE <br />123-040 Project Name: VPA Athletic Court Renovations,_ Phase_3.2023 _ <br />,Milestone Contractors North, Inc. Total Bid Amount: $1,224,595.55 WBE Goal: 3.6% <br />Primary Contact Person <br />(Name/Telephone) <br />i <br />State Barricading, Inc. <br />James Michalski <br />24963 W US Hwy 20 <br />574-287-2078 <br />South Bend, IN 46628 <br />Shoshone Trucking, LLC. <br />Ted Peters <br />3115 W. 300 S. <br />765-689-8900 <br />Peru, IN 46970 <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Traffic Control Devices <br />Hauling <br />f <br />Submitted by: Dustin P. Hilary, Director of Estimating <br />Print Name Signafur <br />Version 4/2/2019 Contractor's Bid for Public Works - <br />Page 1 of 1 <br />'Dollar Amount of WBE f Total <br />Component <br />$28,000.00 1 2.29% <br />$16,100.00 1 1.31 % <br />5/23/2023 <br />Date <br />