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CITY OF SOUTH BEND <br />MINORITY AND WOMEN BUSINESS ENTERPRISE INCLUSION PROGRAM PLAN <br />-, <br />FORM WBE-1.0 -----A ' <br />WBE UTILIZATION PLAN <br />This completed form should be supplies! 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 />C. Lee Construction Services, Inc. <br />Project Number: 123-014 Project Name: Demolition of 1000 West Sample Street <br />Bidder: C.LQ, }ip ,iei t Base Bid Amount * l 17 q q 9 Zo o <br />G. <br />0 WBE Goal: 4.65 /o <br />Page I of <br />Name 8 Address of WBE Primary Gontact Person to be Performed Dollar Amount of WBE Percentage <br />(NamelTelephone) �(Al�tch,,o�pe/schofd�uleifyou need additional spaoe) Com onent of Total <br />p <br />is 11�iu..c�tCl►. C.1.>Et 1N;4� b•c Dtr• <br />e l 1pe a C.ur 41NIC4 , Cdt, of bush <br />'" 81 '/. of + v— -1!%64 cow <br />Submitted by: .Ir dltr1' L 41. <br />Print Name 5ignatu e <br />'Goals should be calcu4 <br />Version 07/19/2023 Contractor's Bid for Public Works - 9 <br />based on the Base Bid only.*** <br />A+M uew4_R <br />a- 17,-24 <br />Date <br />