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ofs°UTU <br />CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN` :, PEACE r <br />FORM WBE-1.0 <br />�1yG5 <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 <br />is the bidder's sole responsibility to verify whether any listed minority or woman business meets the WBE qualifications. <br />Project Number: <br />Bidder: <br />122-064 <br />Project Name: Central Services Parking Lot Repairs <br />Total Bid Amount: <br />WBE Goal: 5.31 % <br />Page of <br />Name & Address of WBE <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 WBE <br />Component <br />Percentage <br />of Total <br />Bid/Pro osal <br />Submitted by: <br />Print Name <br />Version 03/15/2023 <br />Signature <br />Page - 27 <br />Date <br />Public Works Quote <br />