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F, r <br />CITY OF SOUTH BEND d <br />PEACE <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE-1.0 1 <br />1865 <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 />123-044 <br />Project Name: Splashpad Renovations <br />Larson -Danielson Const. Co., Inc. Total Bid Amount: <br />MBE Goal: 1.61% <br />Page 1 of 1 <br />Name & 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 MBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />Submitted by: <br />Brian T. Larson, President <br />Print Name <br />X <br />Signature <br />E<PE LARSOWDANIELSON <br />��AL <br />CONSTRUCTION CO., INC. <br />�IAN <br />Version 09/29/2021 Contractor's Bid for Public Works - 11 <br />Date <br />9/12/23 <br />