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CITY OF SOUTH BENDMINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLANFORM MBE-1.0MBE UTILIZATION PLANVersion 09/29/2021 Contractor’s Bid for Public Works - 8This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving MBE participation. It is the bidder’s sole responsibility to verify whether any listed minority-owned business meets the MBE qualifications.Project Number:122-034Project Name:Fire Station #8 ReplacementBidder: Total Bid Amount: MBE Goal: 3.4%Page_______of___ ____Name & Address of MBEPrimary Contact Person(Name/Telephone)Scope of Work to be Performed(Attach scope/schedule if you need additional space)Dollar Amount of MBE ComponentPercentage of Total Bid/ProposalSubmitted by:Print Name Signature Date Larson-Danielson Construction Company, Inc.11Brian T. Larson, President X 7/25/23LARSON-DANIELSONCONSTRUCTION CO., INC.STATEOFINDIAANSEALCorporatePemberton-DavisSouth Bend, IN Electrical-Using a MBE supplier price not competitiveMike Taff574-277-7011JbL2 Signals & LIghting