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CITY OF SOu H BEND wi f d <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 />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: <br />Bidder: <br />123-013 <br />Project Name: City of South Bend Wayfinding Si na a Program Phase 3 <br />GfLOCSRAPN 1 KJPuSe IZtES, in1G. Total Bid Amount: 2-0y,312- MBE Goal: 0.82% <br />Page 1 ofi� <br />Name & Address of MBE <br />Primary Contact Person <br />Namefrele hone <br />( p ) <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 />C.LSE cot457VLLC,n04 Si <br />tCSAW" EXPRVS6100F /SIC. <br />��� r�x�A�Anr� <br />CS 2IR-$S8 qs <br />S-7y-gy7(._S <br />BIZ-��-6 <br />y ICAtiTACTD -n4ESE 3 CzMPAWIES <br />g J Dp n(OT NA tE PF.pPU L6COTD <br />G9 t�s�vrW 6rzNp <br />GE _: 62014 W 1u. 5U(1FLy ALL LQ&Z�2 <br />i D E)v-Rv -ATE ALL S Fou NfDanaK6 <br />Submitted by: <br />Gca,,a tin )aeP_ <br />Print Name <br />Signature <br />***Goals should be calculated based on the Base Bid only.*** <br />/2-/1-?13Z3 <br />Date <br />Version 07/19/2023 Contractor's Bid for Public Works - 10 <br />