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4 Tli E <br />CITY OF SOUTH BEND <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 or woman business meets the MBE qualifications. <br />Project Number: 123-042 Project Name: Century Center North Restroom Renovation <br />Bidder: Brown & Brown General Contractors, Inc. Total Bid Amount: 2-0-1 , Lo00. Oo MBE Goal: 0.5% <br />Page I 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 />Submitted by: Todd Marek <br />Print Name <br />Signature <br />June 13, 2023 <br />Date <br />Version 03/15/2023 Page - 20 Public Works Quote <br />