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CITY OF SOUTH BEND = x <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN ' x` <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 minority or woman business meets the WBE qualifications. <br />Project Number: <br />Bidder: <br />123-042 Project Name: Century Center North Restroom Renovation <br />Gibson -Lewis, LLC Total Bid Amounfi <br />WBE Goal: 1.5% <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: Robert. A. Lingenfelter, President 7�?oW2, <br />Print Name Signature <br />6/13/23 <br />Date <br />Version 03/15/2023 Page - 21 Public Works Quote <br />