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CITY OF SOu H BEND <br />U <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />FORM WBE-1.0 <br />WBE UTILIZATION PLAN <br />\ x <br />biers„`` - <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 />***Goals should be calculated based on the Base Bid only.*** <br />Project Number: 123-013 Project Name: City of South Bend Wayfinding Si na a Program Phase 3 <br />Bidder: GE040?14 to OJSMIES,111k• Total Bid Amount: Zt3Lf, i2 ,WBE Goal: 3.36% <br />Page J of i <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/Pro osal <br />5� t�RSL1CAO11.1G, i nIC, <br />��96 v5 rac�l 2a <br />3 <br />ilili gtv 1p y 1 rJ u6b2 $ <br />SlaMFS IhfC1�tALS+C <br />574-2�3i- 2d7S <br />TRAFFIC CONTROL. <br />COlz 51 G)1 Ftxria 11,1STRLLAT 16J <br />Jr <br />� �� <br />Submitted by: <br />CSOR6S rn KLUQ16f1Z <br />Print Name <br />Signature <br />***Goals should be calculated based on the Base Bid only.*** <br />is -/r-2aZ3 <br />Date <br />Version 07/19/2023 Contractor's Bid for Public Works - 11 <br />