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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM MBE4.0 <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: 123-011 Project Name: <br />Bidder. HRP Construction Inc. <br />YSB oath Bend Thrive Subdivision Infrastructure improvements _ <br />Total Bid Amount: 4,583,547.00 MBE Goal: Y 1.87 <br />o� 0 1 -1 1 <br />Name S Address of MBE <br />JBL 2 Signals & Lighting <br />4316 Technology Drive <br />South Bend, IN 46628 <br />Primary Contact Person <br />(Name/Telephone) <br />Tanner Leibovitz <br />5 74-855-2251 <br />Scope of Work to be Performed <br />(Attach scope/schedule if you need additional space) <br />Electrical <br />Dollar Amount of MBE <br />Component <br />$91,670.00 <br />Percentage <br />Bid/ProposalofTotal <br />2.0 <br />Submitted by: Matthew D. Cain, President <br />Print Name QSignature <br />Version 09/29/2021 Contractor's Bid for Public Works - 11 <br />September 12, 2023 <br />Date <br />