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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 <br />is the bidder's sole responsibility to verify whether any listed minority or woman business imeets the MBE qualifications. <br />Project Number: 122-064R Project Name: Central Services Parking Lot Repairs <br />Bidder: Milestone Contractors North, Inc. Total Bid Amount: $214,042.00 MBE Goal: 0.8% <br />Page 1 of 1 <br />Name & Address of MBE Primary Contact Person <br />(Namerrele hone) <br />� I P <br />f <br />C. Lee Construction Services, Inc. Frederick "Chip" Lee <br />1011 S. Lake Street 219-922-7733 <br />Gary, IN 46403 j <br />Submitted by: Dustin P. Hilary, Director of Estimating <br />Print Name <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Hauling <br />Dollar Amount of MBE Percentage <br />Component of Total <br />Com <br />P 12;AJt3 ..,.....- <br />$1,800.00 1 0.84% <br />7/11/2023 <br />Date <br />Version 03/15/2023 Page - 26 Public Works Quote <br />