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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 <br />participation. It is the bidder's sole responsibility to verify whether any listed minority -owned business meets the MBE qualifications. <br />Project Number: 122-049 Project Name: Cleveland Road and Ameritech Drive Intersection Improvements <br />c<- <br />Bidder: Premium Concrete Services Inc. Total Bid Amount: p / S/ 7 MBE Goal: 3.53 <br />Page 1 of 1 <br />Name &Address of MBE <br />Primary Contact Person <br />(Name(relephone) <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Dollar Amount of MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />Kennedy Expressline <br />4324 Ashard Dr. <br />South Bend, IN <br />Marcus Northern <br />574-876-8881 <br />Trucking/Material Hauling Services <br />3 `j(v�p <br />Submitted by: Austin Redding 8/8/23 <br />Print Name Sign ure Date <br />Version 09l29/2021 Contractor's Bid for Public Works - 9 <br />