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CITY OF SOUTH BEND <br />W <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: 123-064 Project Name: Liberty Tower TIF Pra ect — Parking Garage <br />Bidder: TI'ISCO Systems, Inc. Total Bid Amount: $1739,860.00 <br />Name & Address of MBE Primary Contact Person I Scope of Work to be Performed <br />I (Name/Telephone) (Attach scope/schedule if you need additional space) <br />Contractor Connection, Inc. Maria Maculaitis Construction Material Supplier <br />1828 Perry Drive SW - Rear 330-479-9894 <br />Canton, OH 44706 <br />Submitted by: Brian U. Walter, Vice President i <br />Print Name Signature <br />Version 09/29/2021 Contractor's Bid for Public Work - 9 <br />MBE Goal: 3.4% <br />Page 1 of 1 <br />Dollar Amount of MBE of Total <br />Component Q;A/Mo -- <br />$59,156.00 1 3.4% <br />September 25, 2023 <br />Date <br />