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4 SOUTH g <br />O End <br />CITY OF SOUTH BEND �� d <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM WBE-1.0 , <br />WBE UTILIZATION PLAN <br />This completed form should be supplied with Bids that pertain to City of South Bend Public Works Projects involving WBE participation. It is <br />the bidder's sole responsibility to verify whether any listed woman -owned business meets the WBE qualifications. <br />Project Number: <br />Bidder: <br />123-044 Project Name: Splashpad Renovations <br />Larson -Danielson Const. Co., Inc. Total Bid Amount: <br />WBE Goal: 3.83% <br />Page 1 of 1 <br />Name & Address of WBE <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 WBE <br />Component <br />Percentage <br />of Total <br />Bid/Proposal <br />Submitted by: <br />Brian T. Larson, President <br />Print Name <br />Signature <br />LARSON-DANIELSON <br />%SFAL CONSTRUCTION CO., INC. <br />�rA�P <br />Version 09/29/2021 Contractor's Bid for Public Works - 12 <br />9/12/23 <br />Date <br />