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/ter TH <br />kkN <br />CITY OF SOUTH BEND U o <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: 122-059 Project Name: <br />Bidder: Milestone Contractors North, Inc. <br />Name & Address of MBE <br />JBL2 Signals & Lighting <br />4316 Technology Drive <br />South Bend, IN 46628 <br />Primary Contact Person <br />(Name/Telephone) <br />Tanner Leibovitz <br />574-855-2251 <br />Submitted by: Dustin P. Hilary, Director of Estimating <br />Print Name <br />Angela Boulevard Roadway Improvements <br />Total Bid Amount: $3,560,00.00 <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Signalization <br />Version 09/29/2021 Contractor's Bid for Public Works - 12 <br />MBE Goal: 3.3% <br />Page 1 of 1 <br />Dollar Amount of MBE Percentage <br />Component of Total <br />Bid/Proposal <br />$140,000.00 <br />6/13/2023 <br />Date <br />3.93% <br />