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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 is <br />the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. <br />Project Number: <br />Bidder: <br />121-066 <br />Project Name: Pure Green Farms Site Improvements <br />C= 4- c' e5CCIPI 114 � Total Bid Arnount:4, G 1 MBE Goal: 2.7% <br />Page_ of. <br />Name 8, 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 NABE <br />Component <br />Percentaof Totage <br />Bid/Proposal <br />E�r��tSt•�'�e, <br />Ihu.��.rsS �o.^��.-,� <br />'(rL�icr� � ��.�1 ,`.'�" <br />I <br />[ij''}L.r�/.�e,�}- <br />13�4 '4f nJZa <br />f�j <br />/ C> <br />�C— <br />r �d <br />q6 CIOLg <br />t4/ <br />Submitted by: � nr a v; c�r',< -7 - // �- a?, 3 <br />Print Narm�— Signature Date <br />Version 09/2912021 Contractor's Bid for Public Works - 9 <br />