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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN PFACL <br />FORM WBE-1.0/� <br />WBE UTILIZATION PLAN ram; <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: 122-064R Project Name: Central Services Parking Lot Repairs <br />Bidder: Rieth-Riley Construction Total Bid Amount: $250,581.51 WBE Goal: 3.1% <br />Page 1 of 1 <br />Name & Address of WBE <br />Primary Contact Person <br />Scope of Work to be Performed <br />Dollar Amount of WBE <br />Percentage <br />of Total <br />(Name/Telephone) <br />(Attach scope/schedule if you need additional space) <br />Component <br />Bid/Proposal <br />Javelina Construction <br />Tanner Fortune <br />Milling <br />$6,281.20 <br />2.5% <br />13376 Britton Park Road <br />317-841-8364 <br />Fishers, IN 46038 <br />Montgomery Trucking <br />Karen Montgomery <br />Trucking <br />$1,700.00 <br />.67% <br />2207 West Cook Road <br />260-440-3005 <br />Fort Wayne, IN 46818 <br />Submitted by: Garrett VanParys 7/10/2023 <br />Print Name Signature Date <br />Version 03/15/2023 Page - 27 Public Works Quote <br />